Miami, FL (January 9, 2006) — Patients with type 1 diabetes who undergo an islet cell transplant experience an improved quality of life even though they have to take harsh anti-rejection drugs, according to a study just published in the American Journal of Transplantation.
The study was conducted at the University of Miami Leonard M. Miller School of Medicine’s Diabetes Research Institute (DRI), one of the world’s leading centers for islet cell transplantation.
Through interviews and questionnaires, researchers followed 23 patients over more than three years to get a comprehensive gauge of their quality of life, as part of a general psychological evaluation. The patients were evaluated while on the transplant waiting list, and at selected intervals after islet cell transplantation.
“All of the participants in our study belong to a group of patients who have experienced severe hypoglycemic episodes and have hypoglycemia unawareness, meaning they do not realize when their blood sugar level is dropping to a life-threatening level,” said Rodolfo Alejandro, M.D., director of the clinical islet transplant program at the Diabetes Research Institute and author of the study.
“These were criteria to take part in the study, and to undergo an islet cell transplant, because the benefit of good glycemic control must outweigh the risk of chronic immunosuppression.”
In type 1 diabetes the body does not produce insulin, and daily injections are needed. Islet cell transplantation is a groundbreaking procedure that is considered the most promising method for curing diabetes. During the procedure islet cells are separated from a donor pancreas, and infused into a patient’s liver, where they begin to produce insulin.
Almost 80 percent of patients undergoing islet cell transplantation are insulin-free for at least one year, however over time many patients return to needing at least some insulin. “The compromise with the procedure is that the patients must take anti-rejection drugs, so it’s a trade-off between being off insulin and having normal glucose control, or the side effects of these very potent medications,” Alejandro said. “That’s why we needed to prove, by using psychological instruments, whether we were really improving their lives when taking all these things into account.”
The study showed that despite all the patients had gone through, even if they had to go back on insulin they were still experiencing an improved quality of life three years later. All of the patients reported being less concerned about their disease and no longer living in fear of suffering a sudden undetected and life-threatening drop in their sugar levels. Interestingly, the researchers saw a decline in patients’ worrying as soon as they went on the transplant waiting list.
“We feel that drop in worry was due to the fact that they were now being closely and constantly monitored by a team of experts on almost a daily basis while they waited for transplant,” said Dr. Alejandro. “Even though we see this benefit to quality of life after three years, we still have concerns long term because these anti-rejection medications are very powerful.
We need to find a way to one day do these procedures without immunosuppression — that is the new frontier.”
The Diabetes Research Institute is one of only five centers worldwide to receive funding from the National Institutes of Health for clinical islet cell transplant trials.
Jeanne Antol Krull
UM Leonard M. Miller School of Medicine