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Insulin-producing cells transplant can treat Type 1 diabetes

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Posted: Monday, May 13, 2013 4:30 am

MINNEAPOLIS — Dave Thoen feared being alone at night, knowing he could be blindsided at any time by a debilitating, even deadly, seizure.

The Bloomington, Minn., actuary suffered from both diabetes and a condition called “hypoglycemic unawareness,” which blocks the telltale signs of low blood sugar. Despite frequent blood tests and obsessive attention to diet and exercise, seizures could strike him like a hammer — like the blackout that occurred one night during a business trip to Los Angeles. When Thoen regained consciousness, he found himself locked outside his room and covered in blood. His spasms apparently had caused him to bang his head repeatedly into the nightstand.

“I literally had to crawl to the hotel desk,” Thoen recalled.

Today those fears are a memory. Thoen is one of 48 people to receive a set of groundbreaking experimental treatments at the University of Minnesota, which proved that transplants of insulin-producing cells known as “islet cells” can treat — and sometimes cure — Type 1 diabetes, one of the nation’s most serious health scourges.

After more than three decades of research, a consortium of schools that includes the University of Minnesota has completed testing on the transplant technique. Now, the university is preparing to apply to the U.S. Food and Drug Administration for a license to become a manufacturing facility. University officials said a “biological drug license” would allow them to commercialize the new treatment, which has cost the university at least $25 million in grants and donations so far. That, they said, would represent a unique example of a university bringing a new treatment directly from academic research to human applications without any company funding.

“That is completely and entirely unheard of,” said Dr. Bernhard J. Hering, who directs the project at the university.

Waiting on FDA’s approval

If the FDA approves, Hering said, a doctor will be able to prescribe human islets instead of insulin injections. Somewhere between 60 and 70 percent of patients who receive the cells could expect to remain insulin-free after five years, Hering said.

Even those who must still take some insulin, like Thoen, said the operation is life-changing. Before the treatment, Thoen said, he felt guilty relying on family and friends to take care of him. After the treatment, he was able to take his two boys to the Boundary Waters Canoe Area Wilderness on a camping trip, something he said he wouldn’t have dared in the past.

“The transformation for me has been just absolutely amazing,” he said.

Some 26 million Americans have diabetes, and the number is growing at a pace that the U.S. Centers for Disease Control and Prevention has called “unsustainable.” About 95 percent have Type 2 diabetes, which is often caused by poor diet and insufficient exercise. It occurs when islet cells in the pancreas fail to produce enough insulin — a hormone that converts food into glucose — or when the cells cease to recognize it.

About 1.5 million people have Type 1 diabetes, which results when the body’s autoimmune system destroys its own islet cells. Of those, 100,000 share Thoen’s condition of hypoglycemic unawareness.

People with unregulated diabetes face serious complications including blindness, heart and kidney failure, sexual dysfunction, nerve damage and death.

Stephanie Arneson, 49, of Rogers, Minn., was diagnosed with Type 1 diabetes at age 3. She tried everything to regulate her blood sugar, including an insulin pump, changes in her injection regimen and special training programs.

“Nothing seemed to help,” Arneson said. “I would have the ambulance at my house three times a month.”

The disease led to blindness in her left eye.

The last straw came when Arneson blacked out while driving and hit a concrete wall. Her doctor referred her to the experimental transplant program at the University of Minnesota. She rejected her first donor cells in 2001. But two additional transplants in 2003 took, and she’s been insulin-free since.

Arneson, a human relations worker and mother of two daughters, said she never knew life without diabetes until then. In the past, for example, feelings of thirst indicated high blood sugar. She called Hering in a panic one time thinking that she must be rejecting her islet cells because she was thirsty, but her blood tests were normal.

“He said, ‘Stephanie, people get thirsty,’” Arneson recalled. “This whole normal thing is so hard to get used to.”

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