A cure for Type 1 diabetes has been possible by whole pancreas or islet cell transplantation for a number of years. The success of transplants has improved significantly over recent years. Scientists are actively pushing forward with stem cell research so as to try to find a way to overcome the main limitation of islet cell transplantation. This very simply put is a lack of cadaver material for transplantation. The very limited lack of donor pancreas material means that transplants are offered in only a very small minority of patients. It is hope that stem cells can be grown in the laboratory and provide a limitless supply.
As with pancreatic transplants, successful stem cell transplants for diabetes is hampered by two other limiting factors. First, foreign pancreas cells will be rejected by the recipient and necessitates the need for long-term anti-rejection drugs. Second, as Type 1 diabetes is an autoimmune disease where the patient�s own immune system attacked the pancreas in the first place, the destructive process will continue to cause harm to any newly transplanted cells unless measures are taken to protect them.
There are currently a variety of interesting scientific approaches to solving these problems. This may lead potentially and eventually to finding a stem cell therapy cure for Type 1 diabetes but we are a long way off this holy grail at the moment.
As an example, one idea has been to take skin tissue from individual patients with diabetes, induce pleuripotent stem cells from these cells and then to create a supply of functioning beta cells from the stem cells. The technique could if successful provide an individual patient with a supply of their own genetically compatible transplantable pancreatic islet cells eliminating the requirement for anti-rejection drugs. There is a long way to go before this optimism fulfils its clinical potential. There is still the problem with this method of autoimmune attack from the patients own immune system but it does potentially solve the problem of rejection.
A second and very interesting further stem cell approach to curing diabetes involves protecting stem cells from immune attack by developing them within a transplantable encapsulated device. Human embryonic stem cells can be matured into functioning pancreatic beta cells within an encapsulated membrane. This can then be placed in the subcutaneous tissue of a patient with the aim of re-providing a source of insulin production previously lost during the development of diabetes.
Experiments have already been successful in mice. Results proved that this system offers the necessary immunoprotection and proved that these devices can be stable, biocompatible, non degradable. In addition the devices offers the new cells an environment to thrive and secrete insulin. The next stage is to get it working in humans but again there are very significant safety issues. The science behind the work however is fascinating and exciting. A good choice to delve into progress in this area is to review the work of Professor Camillo Ricordi at the Diabetes Research Institute, University of Miami, Florida.
All the points discussed above must be very thoroughly researched and established by large-scale clinical trials before any doctor could safely recommend stem cell therapy to their patients. This has simply not happened at the moment.