The future of pancreas transplantation
Ultimately, the goal of the treatment of type 1 diabetes is to provide insulin therapy that would maximally repeat the rhythm of pancreatic insulin release. Perhaps the most appropriate treatment currently available is pancreatic transplantation. Several approaches to pancreatic transplantation are currently being studied, including transplanting a whole gland or isolated islet cells (these groups of cells contain beta cells that are responsible for insulin production). Data available since 1995 indicate that nearly 8,000 patients underwent pancreatic transplant surgery. Most patients underwent pancreatic transplantation simultaneously with kidney transplantation due to diabetic kidney damage.
The transplant procedure has its risks. Both surgical intervention and subsequent immunosuppressive therapy pose a significant risk to patients. Therefore, kidney and pancreas transplants are usually performed simultaneously. Currently, there is a mismatch between patients who can undergo whole pancreas transplantation but who do not need kidney transplantation. In addition, it remains controversial whether the benefits outweigh the potential risks. There is also a chance of developing diabetes in a transplanted pancreas. So selective islet cell transplantation is an interesting alternative to whole pancreas transplantation. Although still there are questions regarding the rejection reaction. Studies are in full swing to mask islet cells under tissues that the body will not tear away (for example, placing islet cells in the patient’s own cells with their subsequent implantation). In addition, researchers are studying artificial barriers that can surround islet cells, providing protection against rejection and allowing insulin to enter the bloodstream.
The next few years promise to give many interesting results in the treatment of diabetes. Many drugs for the treatment of type 2 diabetes are under development, approaches to insulin therapy continue to develop, and methods for delivering insulin to the blood stream are being improved. As research continues in this area, one thing remains constant. In type 1 and type 2 diabetes, the primary goal is to achieve the best control of blood sugar. Currently, we no doubt know that good blood sugar control reduces the likelihood of developing long-term complications of diabetes, including blindness, damage to nerves and kidneys. In addition, a healthy lifestyle is very important, it should remain the cornerstone in the treatment of diabetes.
Diabetes at first glance
- Diabetes mellitus is a chronic condition associated with abnormally high levels of blood sugar (glucose).
- Insulin, which is produced by the pancreas, lowers blood glucose.
- The absence or insufficient production of insulin causes diabetes mellitus.
- There are two types of diabetes mellitus 1 (insulin-dependent) and 2 (non-insulin-dependent).
- Symptoms of diabetes include: rapid urination, thirst, hunger, and weakness.
- The diagnosis of diabetes is based on a blood test for sugar (glucose).
- Complications of diabetes can be both acute and chronic.
- Acute: dangerously high or dangerously low blood sugar levels may develop (due to the use of antidiabetic drugs).
- Chronic: diseases of the blood vessels (both small and large) that can damage the eyes, kidneys, nerves and heart
- Treatment for diabetes depends on its type and severity. Type 1 diabetes is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes is primarily treated with weight loss, a diabetic diet, and exercise. When all these measures cease to provide effective control of blood sugar levels, oral medications are started. If these drugs also do not give an effect, the question of the use of insulin is considered.
When transplanting islet cells to a person with diabetes, insulin-producing beta cells taken from a donor pancreas are transplanted. These transplanted donor cells begin to produce and release insulin, actively regulating blood sugar levels.
What are the benefits of islet cell transplantation?
Successful transplantation of islet cells significantly improves the quality of life of a person with diabetes.
Transplanted islet cells automatically control the sugar level in the body and can regulate insulin levels, supplying the necessary amount to normalize the blood sugar concentration even when the needs of the body change (for example, after exercise or eating).
Successful islet cell transplantation can provide the following benefits:
- It can eliminate the need for frequent measurements of blood sugar and the need for daily insulin injections. Although, after a year after transplantation, only a small number of people can completely refuse to administer insulin.
- It may allow you to stick to a more advanced diet.
- It can help protect against serious long-term complications, including heart disease, kidney disease, stroke, and nerve and eye damage.
What are the risks of islet cell transplantation?
As with any organ or tissue transplant, the biggest problem is donor cell rejection by people with diabetes. The immune system protects the body from substances that “invade” it, for example, bacteria and viruses. Even with the transplantation of the necessary donor tissue, the recipient’s immune system recognizes it as “foreign” and tries to destroy it. This attack on donor tissue is called “rejection”.
All transplant recipients must take strong medications that suppress the immune response and prevent rejection until the end of their lives. Many of these drugs have serious side effects. The long-term effects of these immunosuppressive drugs or drugs that prevent the development of the rejection reaction are still unknown, but there is reason to believe that they increase the risk of cancer.