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    Stem Cells May Stop Type 1 Diabetes

    Blood Stem Cell Transplant Leaves Diabetes Patients Insulin Free -- So Far
    By
    WebMD Health News
    Reviewed by Louise Chang, MD

    April 10, 2007 -- After transplants of their own blood stem cells, 14 of 15 type 1 diabetes patients are insulin free for one to 36 months -- and counting.

    In type 1 diabetes, the body can't make the insulin it needs, and so insulin injections are necessary for treatment. After their transplants, most of the patients in the study became free from insulin injections.

    It's the first time the treatment has been used in type 1 diabetes, although it's helped patients with other autoimmune diseases. The early success is encouraging -- but nobody is using the word "cure."

    It's not yet clear exactly how the stem cell treatment works, or even whether it truly works at all. And it's far from clear how long treated patients will remain insulin free.

    "Very encouraging results were obtained in a small number of patients with early onset disease," conclude researchers Júlio C. Voltarelli, MD, PhD, of the University of São Paulo, Brazil, and colleagues.

    The researchers warn that longer follow-up of trial patients, further biological studies, and, finally, a clinical trial will be needed to confirm that the treatment works. Their report appears in the April 11 issue of TheJournal of the American Medical Association.

    Early Results, Enormous Promise

    In type 1 diabetes, haywire immune cells attack the insulin-making beta cells in the pancreas. This means people with type 1 diabetes can't make the insulin they need and require the use of supplemental insulin. The goal of the treatment is to get rid of these bad immune cells and to replace them with immature cells that have not yet learned bad habits -- thus stopping beta-cell damage and restoring proper immune function.

    The treatment is called autologous nonmyeloablative hematopoietic stem cell transplantation. It's a four-step process:

    1. Soon after diagnosis of type 1 diabetes -- while a person still has plenty of beta cells left -- the patient is given drugs that stimulate production of blood stem cells.
    2. The blood stem cells are removed from the patient's body and frozen for later use.
    3. The patient is given drugs and antibodies that kill off immune cells, leaving other blood cells intact.
    4. The blood stem cells are reinfused into the patient.

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