Standard Treatment
For patients with type 1 diabetes and those who have undergone total pancreatectomy, the current standard treatments are insulin replacement therapy and islet transplantation. Insulin therapy remains essential for maintaining glycemic control, though it imposes a significant burden due to frequent injections and the need for constant self-monitoring. Islet transplantation offers the potential to restore endogenous insulin secretion, but its broader application is limited by challenges such as donor shortage and the need for lifelong immunosuppression.
Insulin Injection
What is Insulin Injection?
In type 1 diabetes, the body's ability to produce insulin is severely impaired or completely lost due to the destruction of pancreatic β-cells. As a result, external insulin supplementation becomes essential to maintain metabolic balance.
Insulin injection is the core component of insulin replacement therapy. It involves the regular and controlled administration of insulin to keep blood glucose levels within a target range. This treatment is crucial for preventing blood glucose fluctuations and reducing the risk of diabetes-related complications.
Challenges of Insulin Injection
Effective insulin injection therapy requires frequent blood glucose monitoring and precise dose adjustments based on factors such as meals, physical activity, stress levels, and individual metabolic responses. This complex self-management imposes a significant daily burden on patients with type 1 diabetes and their families.
A major clinical challenge is the risk of hypoglycemia caused by excessive insulin dosing. Severe hypoglycemia can lead to loss of consciousness, coma, and in extreme cases, can be life-threatening. Avoiding such outcomes requires continuous vigilance and experience, which can significantly reduce the patient's quality of life.
Consequently, there is a strong and growing demand for the development of safer, more user-friendly, and less burdensome alternatives to insulin injection therapy. Advances in regenerative medicine and cell-based approaches offer promising avenues to address this unmet medical need.
Islet Transplant
What is Islet Transplant?
Islet transplantation is a regenerative procedure in which insulin producing islets of Langerhans are isolated from a donor pancreas and infused into the recipient’s portal vein, where they engraft within the liver. The primary goal is to restore endogenous insulin secretion, offering patients with type 1 diabetes or those who have undergone total pancreatectomy a chance to achieve stable glycemic control without intensive exogenous insulin therapy. By re establishing physiologic insulin production, the procedure aims to reduce the risk of severe hypoglycemia and improve overall quality of life.
Challenges of Islet Transplant
Islet transplantation has the advantage of eliminating the need for frequent insulin injections, but the challenges are the shortage of donors and the requirement for long-term use of immunosuppressive drugs. Immunosuppressive drugs must be used for life because without the drugs the immune system will reject the cells. However, side effects such as cancer and kidney damage are problems associated with the long-term use of immunosuppressive drugs. Another problem is that about 60% or more of islet cells die due to inflammation during transplantation.
95% of patients are diagnosed in childhood. However, islet transplantation is not suitable for pediatric patients.
Therefore, islet transplantation therapy remains a challenge to provide satisfactory treatment for all patients with type 1 diabetes, including reducing the burden of glycemic control.