Islet Cell Transplantation: Can It Facilitate Insulin Independence?

By Jessica Kaylor, BA, and John S. Steinberg, DPM

Do islet cells hold promise in treating diabetes? Islet cells are groupings of hormone-secreting cells in the pancreas that are responsible for several endocrine functions including the production of insulin. Pancreatic islets contain four different types of cells including: insulin-producing beta cells, glucagon-releasing alpha cells, somatostatin-producing delta cells and cells that contain polypeptides (PP cells). Each individual islet contains approximately 1,000 of these four types of cells.    In islet cell transplantation procedures, surgeons use enzymes to extract islet cells, typically from the pancreata of multiple deceased donors, in order to collect an ample amount of cells that can be immediately injected into the recipient’s liver. The surgeon would make an injection through the portal vein of the liver in order to facilitate easy access and maintain a minimal level of invasiveness. The cells remain in the liver, attach themselves to new blood vessels and begin to produce insulin from that location.1    After a period of acclimation in the recipient’s system, the transplanted cells produce insulin and regulate the patient’s blood glucose level. As a result, the need for an insulin injection regimen or total pancreas transplant could be eliminated.2 This procedure has gained considerable attention in the medical community due to its extreme potential for benefit to people with diabetes. However, significant advancements are still necessary in order for islet cell treatment to become a comprehensive cure for diabetes mellitus type 1, in which insulin production is absent.    Healthy glucose levels are crucial in decreasing the risk of common complications of diabetes mellitus. These complications include nerve, eye and limb degeneration, particularly of the foot. Typically, one attains euglycemia through a regimen of insulin injections, which are not ideal due to the pain involved and their relative inconvenience. Elimination of a shot regimen is of particular interest for juvenile patients who struggle with the considerable burden and responsibility involved in this glucose regulation method.

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