The Islets of Langerhans aren’t the latest posh getaway destination for the jet-set. They aren’t found on a map at all. They’re found in your body – in your pancreas, to be exact. Though there are five kinds of islet cells, the most common islet cell is the beta cell. This is the cell that produces the insulin your body uses to regulate blood glucose levels. In people with Type 1 diabetes, the body’s autoimmune system turns on itself by attacking and destroying these beta cells. This leaves the body unable to produce insulin; hence, the need for injectable insulin.
But an exciting new development in the field of diabetes care has emerged in the past few years: the transplant of islet cells from healthy organs to people who suffer from Type 1 diabetes. The transplanted islet cells produce insulin, leading scientists to hope that someday patients will no longer need their daily dose of injectable insulin. According to a 2006 report of the Collaborative Islet Transplant Registry, islet transplants offered the benefit of “insulin independence” for some patients, meaning that the patients could go for up to two weeks without injecting insulin. Other benefits were reduced dosage of insulin for patients who still needed daily injections, better blood glucose control, and a significantly reduced risk of hypoglycemia.
But islet transplantation is far from the miracle cure for Type 1 diabetes. The same study reported that over time, insulin independence seemed to wear off. And, as with any surgery, there are risks. Bleeding and blood clots are still serious possible complications, and rejection of the new cells is always a possibility. Patients of islet transplant surgery must continue to take immuno-suppressive drugs for as long as the new islet cells function—which could be for life. The side effects can be daunting, too: gastrointestinal problems, increased cholesterol, hypertension, and increased risk of cancer are only a few of the possible effects.
Further breakthroughs may be at our doorstep. A new class of drug, the anti-CD3 antibody, is currently being developed. CD3s are the immune T-cells that cause the body’s destruction of its own islet cells. It is hoped that the anti-CD3 drugs will delay or prevent this destruction, circumventing the need for islet transplant surgery. Immunologist Herman Waldmann, who pioneered this idea beginning in 1993, likened it to orchestrating a “cease-fire” in the body’s immune system. Clinical trials are still underway for this promising treatment for Type 1 diabetes.