Stem Cells Promising for Type 1 Diabetes
Insulin No Longer Needed by Some Diabetic Patients Who Underwent Experimental Treatment
Stem Cells for Diabetes continued...
The treatment, called autologous nonmyeloablative hematopoietic stem cell transplantation (HSCT), involved several steps.
Soon after diagnosis, the patients were given drugs to stimulate production of blood stem cells. The blood stem cells were then removed from the body and frozen.
Patients were hospitalized and given the toxic drugs that killed their circulating immune cells, and then the harvested blood stem cells were put back into the patient.
The first patient to receive the treatment did not improve, probably because he had too few functioning insulin-producing cells left.
But 20 of the next 22 patients treated with the experimental therapy were able to do without insulin injections or greatly reduce their insulin use for a few months to several years.
Patients who remained insulin-independent showed significant improvement in their ability to produce insulin two years after treatment, compared to pre-treatment production levels.
The ability to show direct improvement in insulin-producing cell function is important because critics have questioned whether the treatment really works.
Soon after being diagnosed with type 1 diabetes, many patients enter what is known as a “honeymoon” period, thought to result from improved diet and lifestyle.
It has been suggested that the early improvements seen in the patients who got the stem cell treatment was because of this lifestyle-related remission and not the treatment.
“This treatment actually stopped the autoimmune process and the remaining [insulin-producing] cells that were not destroyed worked well enough to keep many of these patients off insulin,” Nathan says.
FDA Considering Larger Trial
Study co-author Richard Burt, MD, of the Northwestern University Feinberg School of Medicine, concedes that the side effects seen with the treatment were not negligible, but he adds that the approach is far less toxic than immune system-suppressing therapies given to cancer patients.
“I think people will have to judge for themselves if the potential risks of this treatment outweigh the long-term risks associated with type 1 diabetes progression,” he tells WebMD.
The treatment has not been tried in young children. The youngest study participant was 13 and the oldest was 31.