Chicago – Thirteen young diabetics in Brazil have ditched their insulin shots and need no other medication thanks to a risky but promising treatment with their own stem cells – apparently the first time such a feat has been accomplished.
Though it’s too early to call it a cure, the procedure has enabled the young people, who have Type I diabetes, to live insulin-free so far, some as long as three years. The treatment involves stem-cell transplants from the patients’ own blood.
“It’s the first time in the history of Type 1 diabetes where people have gone with no treatment whatsoever … no medications at all, with normal blood sugars,” said study co-author Dr. Richard Burt of Northwestern University’s medical school in Chicago. While the procedure can be potentially life- threatening, none of the 15 patients in the study died or suffered lasting side effects. It didn’t work for two of them.
Larger, more rigorous studies are needed to determine if stem- cell transplants could become standard treatment for people with the disease once called juvenile diabetes. It is less common than Type 2 diabetes.
The patients involved were ages 14 to 31 and newly diagnosed with Type 1 diabetes. An estimated 12 million to 24 million people worldwide – including 1 million to 2 million in the U.S. – have this form of diabetes. An autoimmune disease, it occurs when the body attacks insulin-producing cells in the pancreas. Insulin is needed to regulate blood-sugar levels, which when too high, can lead to heart disease, blindness, nerve problems and kidney damage.
Burt said the stem-cell transplant is designed to stop the body’s immune attack on the pancreas. The 15 diabetics were treated at a bone-marrow center at the University of São Paulo. All were newly diagnosed, before their insulin-producing cells had been destroyed.
That timing is key, Burt said. “If you wait too long,” he said, “you’ve exceeded the body’s ability to repair itself.”
The procedure involves stimulating the body to produce new stem cells and harvesting them from the patient’s blood. Next comes several days of high-dose chemotherapy, which virtually shuts down the patient’s immune system and stops destruction of the few remaining insulin-producing cells in the body. This requires hospitalization and potent drugs to fend off infection. The harvested stem cells, when injected back into the body, build a new, healthier immune system that does not attack the insulin-producing cells.
Patients were hospitalized for about three weeks. Doctors changed the drug regimen after the treatment failed in the first patient. Another patient also relapsed. The remaining 13 “live a normal life without taking insulin,” said study co-author Dr. Julio Voltarelli of the University of São Paulo.
Burt has had some success using the same procedure with other autoimmune diseases, including lupus and multiple sclerosis; one patient with an autoimmune form of blindness can now see, Burt said.
