US scientists have demonstrated a method of achieving insulin independence within type 1 diabetes.
The technique involves islet cell transplantation within a tissue-engineered platform, which could provide a life-changing treatment option for people with type 1 diabetes.
Researchers from the Diabetes Research Institute (DRI) at the University of Miami Miller School of Medicine say this is the first tissue-engineered “mini pancreas” that has led to long-term insulin independence in someone with type 1 diabetes.
This mini-pancreas device is the DRI BioHub, a biological platform made by a combination of donor islets with a patient’s own blood plasma.
DRI scientists have been testing the effects of layering this islet/plasma mixture onto the omental, a tissue which covers abdominal organs and is easily accessed with minimally invasive surgery.
When a molecule called thrombin is added to the mixture, a gel-material is created that sticks to the omentum and holds the islets in place. Over time, the body absorbs the gel and leaves the islets intact.
Stable glycemic control
The scientists tested this transplantation of a 43-year-old woman with type 1 diabetes who had hypo unawareness and episodes of severe hypoglycemia.
The patient received over 600,000 islet equivalents; her insulin was discontinued after 17 days. The transplantation led to her becoming insulin independent, and while some decline was observed at 12 months, she still has stable glycemic control without insulin.
“The results thus far have shown that the omentum appears to be a viable site for islet implantation using this new platform technique,” said lead author Dr David Baidal.
“Data from our study and long-term follow up of additional omental islet transplants will determine the safety and feasibility of this strategy of islet transplantatio, but we are quite excited about what we are seeing now.”
This clinical trial is an important step for the DRI in their development of the DRI BioHub, a mini-organ which the DRI is using in current islet transplantation studies.
The researchers added that “the current study is ongoing to determine the safety and long-term feasibility of this strategy of islet transplantatio,” but stressed that long-term findings are required before the BioHub can be tested in larger studies.
The study has been published in the New England Journal of Medicine.
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