In a nutshell
This study investigated whether a bone marrow transplant is effective in treating recently diagnosed type 1 diabetes.
Some background
Type 1 diabetes (T1D) is an autoimmune disease, meaning that the immune system attacks the cells of the pancreas which produce insulin. Treatments which prevent the immune attack on the pancreas may allow patients to produce insulin again, without the need for insulin injections. As the bone marrow (tissue found in the middle of bones) produces the immune cells, a bone marrow transplant may be used as a new treatment. A bone marrow transplant involves killing the current bone marrow cells with a chemotherapy drug and replacing these cells with new bone marrow stem cells (unspecialised cells which may develop into bone marrow cells). If the patient’s own stem cells are used, the cells will not be rejected. However, patients have a higher risk of infection as all immune cells are initially killed before the transplant.
Methods & findings
This study aimed to determine whether a bone marrow transplant can treat newly diagnosed T1D patients. 65 patients were given two doses of the chemotherapy drug cyclophosphamide (Cytotoxan). Bone marrow stem cells were then obtained from blood samples of each patient. The stem cells were transplanted 5 days later. Participants were followed-up at 6 months, 1 year and 4 years after the transplant.
59% were insulin independent after 6 months and 32% were insulin independent after 4 years. Patients who required insulin injections again injected a lower dose (less than 10 Units per day) after the transplant in comparison to before. The average HbA1c (average blood glucose levels over the past 3 months) among participants decreased from 87.2 mmol/L before transplantation to 42.2 mmol/L after 1 year. The white blood cell (cells of the immune system) count was lower after 1 year, but subsequently recovered. Side effects such as fever and alopecia (hair loss) were experienced in 52% of patients. One out of the 65 participants died as a result of a fungal infection.
The bottom line
This study concluded that bone marrow transplantation is effective in treating T1D; however safer methods are required.
The fine print
The side effects may reduce the clinical application of this potential treatment. Also, this bone marrow transplant has only been shown to be effective in patients recently diagnosed with T1D.
Published By :
Diabetes
Date :
Jun 19, 2014
Hi
is there any real method to treating diabetes type 1?
Due to the fact that T1D is caused by an autoimmune response killing the islet beta cells of the pancreas, the only “cure” right now is either management or total system replacement – involving procedures above or pancreas transplant combined with the above and anti-rejection therapy. There are other beta cell transplantation methods that have been studied, but the key failure is the existing immune system that will continue to attempt to kill them.