Scientists are conducting research on diabetes to further our understanding of the disease. Research currently being done on diabetes includes:
- Prevention of the disease
- Islet cell transplantation
- Alternative therapies
- Genetics and the environment
- Diabetes and kidney disease.
Prevention of Diabetes
Researchers continue to look for the cause or causes of diabetes and ways to prevent and cure the disease. Scientists are searching for genes that may be involved in type 1 or type 2 diabetes. Some genetic markers for type 1 diabetes have been identified, and it is now possible to screen relatives of people with this type to determine whether they are at risk of also developing the condition.
Islet Cell Transplantation
Researchers are working on a way for people with type 1 diabetes to live without daily insulin injections. In an experimental procedure called islet cell transplantation, islets are taken from a donor pancreas and transferred into a person with type 1 diabetes. Once implanted, the beta cells in these islets begin to make and release insulin.
Scientists have made many advances in islet transplantation in recent years. Since reporting their findings in the June 2000 issue of The New England Journal of Medicine, researchers at the University of Alberta in Edmonton, Alberta, Canada, have continued to use a procedure called the Edmonton protocol to transplant pancreatic islets into people with type 1 diabetes.
A multicenter clinical trial of the Edmonton protocol for islet transplantation is currently under way, and results will be announced in several years. According to the International Islet Transplant Registry, as of June 2003, about 50 percent of the patients have remained free of the need for insulin injections up to one year after receiving a transplant.
The goal of islet transplantation is to infuse enough islets to control the blood glucose level without insulin injections. For an average-sized person (70 kg -- about 154 pounds), a typical transplant requires about 1 million islets, extracted from two donor pancreases. Because good control of blood glucose can slow down or prevent the progression of complications associated with diabetes (such as nerve or eye damage), a successful transplant may reduce the risk of these complications; however, a transplant recipient will need to take immunosuppressive drugs to stop the immune system from rejecting the transplanted islets.
Researchers are trying to find new approaches that will allow successful transplantation without the use of immunosuppressive drugs. These drugs have significant side effects, and their long-term effects are still unknown. Immediate side effects of immunosuppressive drugs may include mouth sores and gastrointestinal problems, such as stomach upset or diarrhea. People may also have:
- Increased blood cholesterol levels
- Decreased white blood cell counts
- Decreased kidney function
- Increased susceptibility to bacterial and viral infections.
Taking immunosuppressive drugs increases the risk of tumors and cancer as well.
Researchers do not fully know what long-term effects islet transplantation may have. Although the early results of the Edmonton protocol are encouraging, more research is needed to answer questions about how long the islets will survive and how often the transplantation procedure will be successful.
A major obstacle to widespread use of islet transplantation will be the shortage of islet cells. The supply available from deceased donors will be enough for only a small percentage of those with type 1 diabetes. However, researchers are pursuing alternative sources, such as creating islet cells from other types of cells. New technologies could then be employed to grow islet cells in the laboratory.