Improved quality of life
in type 1 diabetes patients who had undergone pancreatic islet transplantation
surgeries, was seen in a phase 3
quality of life seen in type 1 diabetes patients after pancreatic islet
number of low blood glucose episodes and better awareness when they occur
improvement also seen in patients who continue on post-transplant insulin treatment.
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.
HypoglycemiaHypoglycemia is a state where the blood glucose levels (blood sugar)
drops lower than normal.
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.
‘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.’
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.
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
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
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.
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."
- 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)