Editorials

Can islet cell transplantation treat diabetes?

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7262.651 (Published 16 September 2000) Cite this as: BMJ 2000;321:651

Small studies show promise, now multicentre trials are going ahead

  1. Steven A White, lecturer,
  2. Michael L Nicholson, professor,
  3. Bernhard J Hering, director of islet transplantation
  1. Department of Surgery, University of Leicester, Leicester LE4 5PW, England
  2. Diabetes Institute for Immunology and Transplantation, University of Minnesota, Box 195, 420 Delaware Street S.E. Minneapolis 55455 United States

    Type 1 diabetes mellitus is a major burden on patients and healthcare economies. The early identification of patients at risk of developing chronic complications would allow timely intervention thus reducing complications, improving the quality of life, prolonging life expectancy, and lowering the cost of treatment. The main determinant of developing chronic complications is prolonged exposure to hyperglycaemia.1 There is no doubt that intensive insulin regimens can reduce the onset and progression of complications from diabetes but they are non-physiological and have an increased risk of causing severe hypoglycaemia. They are also labour intensive and difficult for patients to implement.

    The only way to restore long term euglycaemia is by transplanting a vascularised pancreas. This procedure has been performed in over 15 000 recipients worldwide and has an 85% rate of graft survival at one year— that is, these recipients remained insulin independent.2 During the past …

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