MPR: Hope for Diabetics Could Come from U of M

Hope for Diabetics Could Come from U of M
By Tom Scheck
July 14, 2000

The University of Minnesota's Diabetes Institute will be one of 10 centers throughout the world to participate in clinical trials, to see if a procedure done by Canadian researchers will help diabetes patients. Last month, a New England Journal of Medicine study showed that the procedure in Canada had tremendous success.

Tom Gilmore, U of M scientist analyzes islets under a microscope. (MPR Photo/Tom Scheck)

ABOUT FIVE TO SEVEN times A DAY, Greg Miller has to test his blood to monitor his blood-sugar levels. The 40-year-old Minneapolis man has Type I diabetes, a illness that causes the pancreas to produce little or no insulin. Without insulin, Miller's body can't exchange sugar to energy.

So every time, Miller eats something, he has to prick his finger, place some blood on a monitor and see where his blood-sugar level is. If his blood sugar is too low, it makes him hard to concentrate, if the blood sugar is too high, he gets tired and nauseated.

"I look forward to the day that I don't have to stick a needle in my body, multiple times a day," he says.

Diabetes causes much more damage than a few needle pricks. Damage to the kidneys and the circulatory system tends to occur at higher levels in diabetes patients. Most patients, like Miller, don't know life without those daily shots of insulin.

A study done at the University of Alberta in Edmonton may change that. They've performed a procedure that lets 11 diabetes patients live without a daily dosage of insulin. By transplanting the part of the pancreas that produces insulin - known as the islet - from a cadaver into the liver of a diabetic, researchers found that patients were able to function without insulin injections.

"This is new, this unique and this is wonderful and indicating tremendous progress in the field of islet transplantation," says Dr. Bernard Hering, the director of the islet transplant program at the University of Minnesota.

He says researchers there have started clinical trials similar to the effort in Canada. Hering says a small number of diabetes patients have been living insulin-free after similar transplants, but he says there was a low success rate until the Canadian study.

While Hering says the University of Minnesota is conducting clinical trials to test the best ways of transplanting the islets, he says the "U" has also been selected by the Immune Tolerance Network to test the Edmonton Protocol.

U of M scientist Jeff Ansite prepares a pig pancreas for islet cell transplant. (MPR Photo/Tom Scheck)

At the labs in the wing of the diabetes institute at the "U", scientists Jeff Ansite and Tom Gilmore practice their islet-transplant techniques. Dressed in goggles, hairnets and surgical masks, the group takes a pig's pancreas, cuts it in half and places it in a metal canister with some marbles. Small narrow tubes flush an enzyme solution through the canister. Ansite and Gilmore start shaking the canister, forcing the marbles to break up the pancreas.

After about 20 minutes, the islet separates from the pancreas, then isolated and preserved in a solution.

Scientists say the human trials are not that much different from these animal experiments. After the islet cells are cultured for two to three days so the cells can repair themselves, the islets are then injected into a patient's liver through a catheter. If successful, the islets will start producing enough insulin in the body to regulate it's sugar content.

Dr. Hering says the 10 universities selected, will conduct a total of 40 transplants to see if the Canada study works throughout the world. "One of the outcomes of this trial could be a new standard in the field and then using this standard or using this platform one could move on and test new immunotherapy regimens," he says.

Steven Rose, the chief of the transplant branch at the National Institutes of Health in Washington, says the University of Minnesota was an obvious choice to be involved in the international protocol because the first islet cell transplant happened there in 1974. While he stops short of calling the procedure a cure for diabetes, he says it provides hope for the one million Americans and 40,000 Minnesotans who have Type I diabetes.

"This is an extremely interesting and important advance. I think this is the first time that in islet transplantation, this type of success has been seen."

If the procedure is successful at the "U" and the other institutions, Rose says it's more than likely the procedure will be opened to other patients with Type I diabetes. He says patients will still have to take drugs to stop the body from rejecting the transplant, but he says a couple of pills a day will much easier on people who are accustomed to thousands of shots over a lifetime.

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