The Schulze Diabetes Institute is driven to discover treatments that reverse type I diabetes. We seek to make these treatments readily available so that all patients have the opportunity to live free of the disease.
More than 16 million Americans have diabetes. Of this figure, about 1 million have type 1 diabetes. The remainder are type 2 diabetics.
Of the $100 billion that is spent annually to manage and treat the disease, more than half of this cost is incurred by people with type 1 diabetes. This illustrates the substantial health threat of type 1 diabetes – and the importance of the work we are doing to find a cure.
The Schulze Diabetes Institute is home to the world's largest pancreatectomy and auto-islet transplant program.
During a pancreatectomy, a surgeon removes the patient's pancreas, relieving his or her pain. Without a pancreas, the patient will develop diabetes. In the past, this surgery meant patients had to trade elimination of pain for a lifetime regimen of insulin injections.
Today, There is Another Option
Our physician-researchers have developed a way to eliminate or minimize the need for lifelong insulin after a pancreatectomy through auto-islet transplantation. During this process, islet cells from the patient’s own pancreas are isolated and inserted into the patient's liver where they can continue to produce insulin. No anti-rejection drugs are necessary because the cells are from the patient’s own body.
Both procedures are performed at the University of Minnesota Medical Center, Fairview by surgeons and specialists who are part University of Minnesota Physicians. At present, we are only one of two hospitals in the nation that routinely performs pancreatectomy and auto islet transplants for patients with chronic pancreatitis – and we have a long history of success.
Of our patients who received the auto-islet transplant after pancreatectomy:
- 40% could manage their diabetes without regular injections of insulin
- 90% have some function of the islets long term
Whether or not a patient needs to take insulin after an auto-islet transplant depends on a variety of factors, including the number and quality of islets isolated from the pancreas. All patients receive insulin therapy at least temporarily after surgery. The probability that a person will not need insulin shots is highest in those who have had no previous surgery on the pancreas (such as a Whipple or Puestow).
Of course, there is no guarantee that patients who receive an auto-islet transplant will not become diabetic, however, the Schulz Diabetes Institute is working tirelessly to increase the odds of this life-changing procedure even more.
Physician-researchers at the Schulze Diabetes Institute hope to one day eliminate type I diabetes through islet transplantation. The method used today - in its final stage of clinical trials - is allo-islet transplantation.
This procedure involves inserting islets from a human donor pancreas into the liver. The cells lodge in the liver's small blood vessels and, in most cases, begin producing insulin shortly after infusion.
As is the case for organ transplants, immunosuppressive drugs must be taken to prevent the body from rejecting the cells. Unlike a pancreas transplant, however, islet transplantation does not require major surgery.
During the islet transplant procedure, the patient is under light sedation. The surgeon injects the islets into the portal vein of the patient’s liver. The whole procedure takes 30 minutes to 2 hours.
If successful, the transplanted islets will:
- produce enough insulin so that the transplant recipient will no longer need to take insulin shots or use an insulin pump
- control blood sugar levels in a normal or close to normal range, therefore preventing hypoglycemia (low blood sugar)
With a partially successful transplant, the recipient may benefit from more stable blood sugar control, needing less insulin, with fewer instances of hypoglycemia.
Since 2000, the Schulze Diabetes Institute has completed 4 allo-islet transplant trials involving patients with type 1 diabetes.
None of these patients experienced a serious, unexpected adverse event related to the islet transplant procedure or the immunosuppressive protocol.
- More than 80% of recipients remain protected from severe hypoglycemia 5 years post-transplant
- About 90% of recipients have become insulin-independent post-transplant
- More than 50% have maintained insulin independence at 5-year follow-up
These results are comparable to outcomes previously only attainable by whole-organ pancreas transplantation.
Allo-islet transplants are still experimental, and are currently only being performed in clinical trials; however, planning has begun to apply to the FDA for approval to make allo-islet transplantation available as a clinical treatment.
If you have type 1 diabetes and would like to be considered for or receive information about future islet transplant clinical trials, you can submit your information here.