TYPE 1 DIABETES
You probably know that type 1 diabetes occurs when the pancreas produces little or no insulin. But what causes that disfunction to occur? Type 1 diabetes is an autoimmune disease that occurs when the immune system of the body attacks the cells of the pancreas, making it unable to produce insulin.
Traditional type 1 diabetes treatment consists of a combination of insulin injections, close blood sugar monitoring, diet/lifestyle modification, and often preventative medications to protect heart function.
But even with insulin therapy, maintaining stable blood sugars is extremely challenging for most type 1 diabetics, and experiencing high and low blood sugars is a common event.
This in turn creates numerous complications including an increased risk for stroke and heart disease, and nerve damage known as diabetic neuropathy.
There exists an urgent need for more effective type 1 diabetes treatment, and stem cell research is providing some intriguing possibilities.
USING CORD BLOOD STEM CELLS TO TREAT AUTOIMMUNE FUNCTION
Although the underlying cause of type 1 diabetes is autoimmune disease, most current treatment options do not directly address this factor. One promising study conducted by the University of Florida Health team, is laying groundwork that could change our approach to diabetes 1 treatment, especially in children.
In this study researchers identified a specific type of cell found in umbilical cord blood known as a T cells, or Tregg cells, that support the immune system and help prevent/treat autoimmune diseases including type 1 diabetes. They also discovered a methodology using freezing that allowed them to multiply these cells for greater impact.
According to Dr. Michael Haller, co-author of the study:
“People who develop type 1 diabetes may have an imbalance in the number or function of certain immune cells.
We now have the potential to repair that imbalance by replacing the defective cells. We can take the cells we want from the patient’s cord blood, make more of them in the lab and give them back to the patient with a single infusion.”
Follow this link to learn more about this exciting preliminary study.
USING STEM CELLS TO IMPROVE PANCREATIC FUNCTION
One area that stem cell therapy for type 1 diabetes shows real promise is the replacement of the pancreatic cells that produce insulin. Although the attacks from the immune system continue, this form of treatment attempts to slow down or even stop the deterioration of pancreatic function by replacing cells at an increased pace.
Many stem cell studies are underway, each with its own unique approach and methodology. Here are two such studies, with interesting findings:
UMBILICAL CORD STEM CELL THERAPY COMBINED WITH BONE MARROW TRANSPLANTATION
(In Established Type 1 Diabetes)
The intention of this one year Chinese study was to see if umbilical cord stem cell therapy used in combination with stem cells harvested from bone marrow via transplantation, but without immunotherapy, would be a safe, effective method to improve insulin secretion in established cases of type 1 diabetes.
The results were impressive. At the end of the study the patients that had received treatment showed improved metabolic function, lower HbA1c results, lower fasting blood sugars, an improvement in pancreatic function, lowered insulin dosages, and even decreased levels of depression and anxiety. In, None of these improvements were observed in the control group. In addition, the treatment was deemed safe, with no severe adverse events.
To explore more details, follow this link to the study. https://doi.org/10.2337/dc15-0171
TYPE 1 DIABETES THERAPY USING WHARTON’S JELLY DERIVED- MESENCHYMAL STEM CELLS (MSCs) FROM THE UMBILICAL CORD
(In Early Onset Type 1 Diabetes)
The rather lengthy description of this therapy is with good reason. All stem cells are not created equal. They can be harvested from the umbilical cord, bone marrow, blood, and other body tissues and organs.
Mesenchymal stem cells (MSCs) were chosen for this study because they add an extra bonus– improved immune function, an integral factor in type 1 diabetes treatment. Another characteristic was their ability to hone in on damaged tissue. MSCs can be found in bone marrow, but surgery is required to extract them, so umbilical cord stem cells were used instead.
Again, the results were promising. The patients that received treatment had lower fasting blood sugars and were able to reduce insulin dosages. Patients also showed lowered HbA1c results and increased pancreatic function. The control group (who did not receive treatment) Showed none of these improvements.
No adverse events occurred, and there were no chronic side effects.
Want to know more? Follow this link to read the study for yourself. https://www.ncbi.nlm.nih.gov/pubmed/23154532/
HOW CLOSE ARE WE?
So how close are we to an actual cure? The studies mentioned previously produced improvement in patients, but they were still insulin dependent. An article posted in the American Journal of Stem Cells addressed the “gap between dream and reality” in stem cell treatment for type 1 diabetes. (It should be noted that this article was published in 2015, and many advances have occurred since then)
The article discusses alternative type 1 diabetes treatments that aspire to cure the condition, such as whole pancreas transplant from a donor. While this method has been shown to be highly effective in regulating blood sugars, and does essentially “cure” type 1 diabetes, this highly invasive procedure is not a practical solution for most cases. In addition to the risk of mortality, it requires strict, lifelong immunosuppression which has severe and undesirable side effects including an increased risk for cancer.
Along similar lines, another option is the transplantation of healthy islet (insulin producing) cells into the pancreas. This procedure is essentially non-invasive, but it also requires immunosuppression, and is less effective.
The article concludes that the best treatments, when they are fully developed, will stop the destructive action of the autoimmune dysfunction, and support the regeneration of insulin producing pancreatic cells.
Follow this link to explore the article for yourself. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396156/
TYPE 2 DIABETES
To say that type 2 diabetes is far more prevalent than type 1 diabetes is an understatement. It is an epidemic. According to the American Diabetes Association, out of the 30 million Americans who have diabetes, 95% have type 2 diabetes.
Unlike type 1 diabetics, who have an autoimmune disorder that attacks their pancreas, type 2 diabetics can still produce insulin. However, they are insulin resistant, so it takes increasing amounts of insulin to stabilize blood glucose levels. In addition to this, there is a gradual degeneration of the insulin producing cells in the pancreas (pancreatic beta cells), so less insulin is available. Inflammatory, immune and microvascular abnormalities also play a role.
Treatment for type 2 diabetes includes a wide array of options including diet/exercise/lifestyle, oral medications, injectable medications and insulin. Unfortunately, even when all these options are implemented, type 2 diabetes continues to be a progressive disease with a host of serious complications such as heart disease, kidney disease, nerve damage, foot amputation and pancreatitis.
All this begs the question– isn’t there a better way?
Advocates of stem cell therapy say yes.
STEM CELL THERAPY FOR TYPE 2 DIABETES
One of many studies that supports this optimism was published in the December 6, 2016 edition of Stem Cell Activation. This study explored bone marrow derived stem cell therapy for type 2 diabetes mellitus.
In the study, six patients with type 2 diabetes underwent infusions of stems cells taken from their own bone marrow into the celiac and superior mesenteric arteries (major arteries in the abdomen).
Five of the six experienced lower fasting blood sugars and a drop in HbA1c readings, and were able to reduce their diabetic medications. The three patients who had diabetic complications showed improvement in those conditions as well.
Patients continued to experience these improvements for six months to two years afterward.
The study concluded that while there was a great need for further research to fine tune the details of treatment (such as best stem cell type to use, dosage and administration schedule) their results were consistent with other studies which also created improvement in type 2 diabetes management using stem cell therapy.
Want to learn more about this case study? Follow the link below.
STEM CELL THERAPY FOR DIABETIC COMPLICATIONS
Not only does direct diabetes stem cell treatment offer impressive possibilities, stem cell therapy for diabetic complications is making significant advancements as well.
Mesenchymal stem cells (MSCs), are stem cells that are particularly well suited for diabetes and diabetic complications because of their capacity for self-renewal and regulation of immune response. They also have the ability to “turn into” several different types of cells as needed such as brain cells, vascular cells, skin cells, etc.
The article titled Concise Review: Mesenchymal Stem Cell Treatment of the Complications of Diabetes Mellitus which appeared in the publication Stem Cells, discusses these possibilities based on the results of multiple studies.
The following conditions have shown improvement with Mesenchymal Stem Cell Treatment:
- Impaired Pancreatic Function: MSCs demonstrated the ability to generate new insulin producing cells in the pancreas.
- Diabetic Cardiomyopathy: Diabetic Cardiomyopathy is when a diabetic patient has ventricular dysfunction (problems with heart muscles) although they do not have coronary artery disease, valvular heart disease,
or hypertension. Studies in both humans and animals have shown improvement in cardiac function after MSC treatment.
- Diabetic Nephropathy: Diabetic nephropathy is progressive kidney disease that occurs when diabetes damages blood vessels and other cells in your kidneys. Mice given MSCs showed improved kidney function, and regeneration of the glomerular (tiny blood vessels) structure.
- Diabetic Polyneuropathy: Diabetic Polyneuropathy is nerve damage resulting from high blood sugars, which cause neural cell degeneration and impair blood flow to the nerves. The symptoms include numbness, tingling, and spontaneous pain.
- Diabetic Wounds: When a diabetic receives a wound it can take a very long time to heal, creating a greater risk for infection or additional injury. Diabetic wounds receiving MSC treatment showed an increased rate of healing due to increased production in collagen and improved capillary growth in the wound area.
The one area that science hasn’t quite worked out yet is MSC differentiation. That’s when a stem cell transforms into the type of cell needed to heal a wound or improve an illness. The problem is getting the stem cells to transform consistently the way the physician intended. When this challenge has been overcome, stem cell therapy will be a vital tool in diabetic care.
Want to discover more about stem cell treatment for diabetic complications? Follow this link to read the original article.