36 | March• 2019
DIABETES: WHAT’S NEW AND WHAT’S NEXT
Most people need two consecutive
islet cell transplants to ensure that
the procedure is effective and that the
islets last. (The cells can last for many
years but tend to function for three to
five years.) Patients who receive islet
cell transplants need to take anti-
rejection medication
(immunosuppres-
sion) for the rest of
their lives.
Many people are
able to stop taking
insulin for some
period of time: In a
recent study, when
48 people whose
type 1 diabetes was
extremely difficult
to manage (leading
to life-threatening
low blood sugar
episodes/hypogly-
mia), received is-
ll transplants,
per cent had in
range glucose levels
r later without insulin.
ven if they require some insulin,
an islet transplant can be life-saving
in terms of preventing sudden death
of undetected hypos,” Prof Johnson
says, “and life-improving by helping to
prevent complications such as blind-
ness, kidney failure and heart disease
resulting from high blood sugars.”Adapted from an article by Sari Harrar.
Additional reporting by Victoria Polzot.fix the problem? Islet cell transplants
are available in many countries,
including Australia, Hong Kong, the
UK and some European countries.
HOW THEY WORK Islet cell trans-
plants aren’t for everyone.
“Islet transplantation is only consid-
ered if patients have
been tried on opti-
mal conventional
treatment first,” says
Professor Paul John-
son, director of the
islet transplant pro-
gramme at the Uni-
versity of Oxford.
“They need to have
been treated with
the best possible
modern insulins and
insulin pumps, and
despite that, still be
getting hypoglycae-
mic unawareness.”
It’s a much less
invasive procedure
than a whole pan-
creas transplant: islet cells are typ-
ically injected into the liver via the
portal vein where they start to function
as they would in the pancreas.
“It isn’t a major operation,” Prof
Johnson says. “It’s like having an
intravenous drip run through. Nearly
all the islet transplants are done in the
X-ray department, with the patient
still awake, but with a local anaes-
thetic injection over the liver and
some sedation.”
ISLET CELL
TRANSPLANTS
can prevent
sudden deaths
caused by
undetected
hypogl mice
letonemas