Type 1 Diabetes Patients Report Improved Quality of Life After Islet Transplantation

Transplanting pancreatic islets that make insulin in type1 diabetes patients reduces the episodes of low blood glucose levels leading to a better quality of life.

Highlights:

Improved quality of life seen in type 1 diabetes patients after pancreatic islet transplant
Decreased number of low blood glucose episodes and better awareness when they occur
Similar improvement also seen in patients who continue on post-transplant insulin treatment.

Improved quality of life in type 1 diabetes patients who had undergone pancreatic islet transplantation surgeries, was seen in a phase 3 clinical study. It was conducted by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and published online March 21 in Diabetes Care.

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‘Frequent episodes of low blood glucose levels (hypoglycemia) can be prevented in type 1 diabetes patients, if they undergo pancreatic islet transplantation; better control of blood glucose and increased awareness of hypoglycemia are also achieved.’

Hypoglycemia

Hypoglycemia is a state where the blood glucose levels (blood sugar) drops lower than normal. Patients experience symptoms like tremors, sweating, nausea and heart palpitations. The normal levels can be restored once they eat or drink something immediately. If the levels drop exceedingly low, patients can succumb to injuries, coma, and even death.

Insulin is a hormone produced by the islets of Langerhans in the pancreas and is responsible for maintaining the blood glucose levels. In type 1 diabetes patients, the body’s immune system attacks and destroys the insulin-producing cells in the islets. To overcome the insulin deficiency, the patients take insulin shots. However, the amount of insulin in the shots cannot wholly control the sugar levels, like natural insulin does, and could lead to higher or lower states of glucose sometimes.

Type 1 diabetes patients are also at a disadvantage when it comes to detecting drops in blood glucose levels; they are usually unaware of the drops till the blood sugar reaches alarmingly low states, a state of severe hypoglycemia. At this point, the patients are unable to restore sugar levels to normal.

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Phase 3 clinical study

A total of 48 participants with type 1 diabetes enrolled in the study; they all had hypoglycemic unawareness and received at least one islet transplant. The purified islets were taken from the pancreases of deceased human donors. Hypoglycemic unawareness meant they had an impaired ability to detect sugar drops and experienced frequent episodes of severe hypoglycemic attacks even after receiving proper care.

A survey to assess the quality of life (QoL) of patients before and after the transplant was conducted. Participants had to fill two diabetic-specific surveys and two concerning their general health.

The amount of insulin that would be available after the pancreatic islets were transplanted would be enough for rectifying the impaired hypoglycemic awareness of the patients, and not so much as to fulfill the entire body’s insulin requirement. For this reason, half of the patient’s had to continue taking insulin even after the transplant.

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Overall Results of the Study Post-transplant included:

Forty-two (88%) of the patients experienced fewer hypoglycemic episodes, had better control of their blood glucose levels, and were more aware when the episodes happened.
Quality of life and overall health status improved vastly for the patients in the diabetes front, even though they had to take long-term treatment with immune-suppressing drugs to prevent transplant rejection.
Patients who continued on insulin intake after the transplant also reported similar improvements in their QoL. This could be mainly because they no longer feared of not being aware of blood glucose level dips.

"People with type 1 diabetes who are at high risk for hypoglycemic events have to practice caution every moment, even while sleeping. It is an exhausting endeavor that--like the events themselves--can keep them from living full lives," said NIDDK Director Griffin P. Rodgers, M.D. "Although islet transplantation remains experimental, we are very encouraged by these findings, as we are by the rapid improvements in other treatments to help people with type 1 diabetes monitor and manage their blood glucose, including artificial pancreas technology."

Reference:

Islet transplantation improves quality of life for people with hard-to-control type 1 diabetes - (https://www.nih.gov/news-events/news-releases/islet-transplantation-improves-quality-life-people-hard-control-type-1-diabetes)

Source-Medindia

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