SONOG & KhabarNepal Forum

A treatment involving the transplant of a patient's own stem cells, also known as autologous transplant or self-transplant, could help to reduce or eliminate the need for insulin in people with type one diabetes (formerly known as childhood or insulin dependent diabetes), a new study claims.

Writing in the Journal of the American Medical Association (JAMA), April 11, 2007, the researchers describe the results as "very encouraging".

"Further follow-up is necessary to confirm the duration of insulin independence and the mechanisms of action of the procedure," they add.

"In addition, randomised controlled trials and further biological studies are necessary to confirm the role of this treatment in changing the natural history of type one [diabetes] and to evaluate the contribution of hematopoietic [blood] stem cells to this change."

The study focused on 15 newly diagnosed patients, aged 14 to 31. The American and Brazilian researchers removed stem cells from the patients' blood and stored them in liquid nitrogen.

Then the 15 people were treated with a high dose of immunosuppresors to prevent further destruction of their pancreatic cells responsible for insulin production, effectively destroying faulty the immune-system cells. In type 1 diabetes, a person’s immune system attacks and destroys insulin-producing beta cells in the pancreas. Preserving beta cells is a key concept in the management of type 1 diabetes.

Then the researchers treated stem cells from the patients' blood and then injected them back into the bloodstream. This transplant of blood stem cells is called "autologous nonmyeloablative hematopoietic stem cell transplantation", or AHST. These patient's own stem cells replace the defective cells that cause the disease. Patients spend about three weeks in the hospital and experience problematic chemotherapy side effects such as nausea, hair loss and possible infertility. There's a calculated 1 in 200 chance of dying, although fortunately there were no deaths in the study.

The researchers found that 14 patients became insulin free, one for 35 months while another four were insulin free for at least 21 months, seven for at least six months and two with late response were insulin-free for one and five months respectively.

Lead author Dr. Julio C. Voltarelli, from the Regional Blood Centre in Ribeiro Preto, Brazil, called these results "very encouraging". The type 1 form of diabetes accounts for 5 to 10 percent of the approximately 21 million Americans with the disease.

"For the first time in the history of diabetes, patients are now treatment-free for up to three years," says Dr. Richard Burt, the senior author of the study and chief of the division of immunotherapy at Northwestern University's Feinberg School of Medicine. playfuls.com

What is the difference between the two types of diabetes (I know one you are born with and one you aren't?), and how does one "get" the type you aren't born with?

Type 1 Diabetes is usually diagnosed in children and young adults. Type 1 diabetes is caused by the body's immune system attacking the islets cells of the pancreas. These cells are what produce insulin. Insulin is a hormone which helps the body use sugar for energy. A Type 1 diabetic basically does not produce any of their own insulin and thus is required to take insuling injections to be able to process the sugar created from digesting foods.

Type 2 diabetes is the result when the body does not produce enough insulin or the body becomes resistant to the insulin it produces. This disease is mainly diagnosed in older people and people who have lived a generally unhealthy lifestyle. Type 2 diabetics may have to take insulin injections but often times they can control their blood glucose levels through a combination of proper diet and insulin supplements.

A diabetics life is not easy. You will have to learn to take very good care of yourself. This means watching what you eat, getting regular exercise and keeping a very close tab on his blood glucose levels. The first two things are good for anyone to do but they are VERY important for a diabetic. You do not have to swear off of drinking altogether but neither should you do a lot of heavy drinking. You should probably stay away from high carb drinks like beer and sugary cocktails.

If you are an insulin dependent diabetic then you should learn to spot the signs of hypoglycemia (aka low blood sugar) this is what happens when the insulin you take goes a little hog wild on you and causes your blood glucose to drop below what it should be. The symptoms vary from person to person but in general the thing to look for you acting "drunk". Your speech may slur, you might start sweating profusely, you will probably babble a lot and act really silly or you may act very emotional. In this case feed yourself as soon as you possibly can. It's best to start yourself off with something sugary and then get yourself a real meal soon after that.

The symptoms of hyperglycemia (high blood sugar) are very difficult to spot and in fact it may be almost impossible for you to spot. You will probably get really thirsty, may have to go to the bathroom a lot, may get headaches and a host of other problems. When in doubt check your blood sugar and see where it's at.

You need to take monitoring your blood glucose levels seriously. Also you need to see a doctor every few months to get an A1C test. You can live a very long and happy life if you simply take care of yourself and keep a close eye on your condition. Some things will take some getting used to but it really will benefit you in the long run. You can still lead a very active and fun life and can still go out bar carousing with your friends until you are keeping an eye on your condition.

Something I don't understand is why one is supposed to avoid carbs, but when one has an "attack" they are supposed to chew on some sweets.

Quote:Something I don't understand is why one is supposed to avoid carbs

Diabetics cannot process glucose into energy normally. Carbs are converted into glucose through digestion. A diabetic takes insulin injections to be able to process the sugar. This in and of itself is fine but you don't want to have to take too much insulin too often. It is possible for a diabetic to become resistant to the insulin injections . They need to watch their carb and sugar intake so that they don't have to take any more insulin than is necessary

Quote:but when one has an "attack" they are supposed to chew on some sweets.

Okay, there is no such thing as a diabetes "attack". What diabetics face is two problems, hypoglycemia and hyperglycemia. What you are refering to as an "attack" is hypoglycemia. Hypoglycemia is low blood sugar. This is what happens when some combination of food, insulin injections, and the myriad of body chemicals didn't mesh quit right and the diabetic's blood sugar levels drop to an unhealthy level. This is the time that they need to eat. It is reccomended that they eat sweets because they will work quicker to get their blood glucose levels up to a good level.

Hyperglycemia is high blood sugar and if caught early enough can be treated with an insulin injection. Left unchecked however and it can lead to ketoacidosis which can be very bad and possibly fatal.

This is a good news for everyone.