Diabetes

Scientists Take New Approach to Fighting Type 1 Diabetes

Implants like these two from ViaCyte contain cells that mature into pancreas cells and produce insulin. If they work, they will be a lot simpler than a pancreas transplant.
Implants like these two from ViaCyte contain cells that mature into pancreas cells and produce insulin. If they work, they will be a lot simpler than a pancreas transplant.

In the fight against Type 1 diabetes, drugmakers are pursuing a new line of attack: creating cells that help the body beat the condition.

In Type 1 diabetes, the immune system attacks pancreas cells that make insulin, a hormone that helps cells absorb sugar. Some 1.25 million Americans have the condition, which raises the risk of heart disease, nerve damage, kidney failure and other illnesses. Patients typically tackle the disease with diligent glucose testing and insulin therapy, used to control blood sugar or glucose.

In the past few years, scientists have made significant progress in their efforts to free patients from insulin therapy. Researchers have learned more about how to generate insulin-producing cells in a laboratory and place them into patients, while protecting the cells from the immune system, which would ordinarily reject them. Some are reprogramming the patient’s own cells to retrain them to fight the disease.

“It is [in] no way an easy life trying to manage blood glucose,” says Julia Greenstein, vice president, discovery research, for JDRF, a nonprofit that funds research into Type 1 diabetes.

Currently, a pancreas transplant is the gold standard for freeing patients from insulin therapy because it enables the highest percentage of patients to remain independent of the treatment over the long term, says Peter Stock, a professor of surgery at the University of California, San Francisco, and co-director of the Pancreatic Islet Cell Transplant program at UCSF Medical Center.

But a pancreas transplant is a major surgery, and not every patient has a heart healthy enough to tolerate the procedure. Transplants also require immune-suppressing drugs, which increase the risk of infection and certain cancers. And the procedure requires donor pancreases, which are scarce.

Beyond transplants

A less invasive option, which has been around since the 1980s, is transplanting islets, or clusters of pancreas cells that include insulin-making beta cells. Patients receive them through a direct injection into the vein that leads to the liver. Some islet-transplant recipients can forgo insulin therapy for several years.

Yet islet transplants carry some of the same downsides as full organ transplants. A pancreas must be removed from a deceased donor to obtain the islets, even though the organ isn’t actually being transplanted. And…