After using stem cell therapy in treatment of patients of diabetic foot, the Endocrinology Department of PGI is now planning to start islet cell transplant for treatment of those type I diabetes patients in whom insulin injections cannot control the sugar level in blood.
Islet cells are tiny clusters of pancreatic cells, including beta cells that produce the hormone insulin which helps in the absorption of glucose from the bloodstream. In type I diabetic patients, the beta cells of the pancreas do not make insulin and a person has to take insulin injections daily to survive.
Three or four insulin injections a day are quite normal for diabetic patients. However, in some cases, the glucose level becomes difficult to control and there are wide swings, risking the life of a patient.
“The goal of pancreatic islet transplantation is to help such diabetic patients achieve normal blood glucose levels without daily injections of insulin. It will be helpful for patients with hypoglycemia (sudden decrease in the blood sugar), which is a dangerous situation,” says Dr Rama Walia, endocrinologist from PGI.
Islets from the pancreas of a deceased organ donor are purified, processed, and then transferred to a diabetic patient’s liver. “After the transplant, the islets start making insulin in a diabetic patient. It will result in improved blood glucose control, reducing the need for insulin injections and preventing hypoglycemia,” says Dr Rama.
“The only risk factor which is associated with this transplant, like any transplant, is the side effects from immunosuppressive medications. A transplant recipient has to take these medications in order to stop the immune system from rejecting the transplanted islets,” she adds.
Islet cell transplant is being done in the USA and the UK for over a decade now. In india, it is done in some private institutions, but not in any government hospital. Dr Anil Bhansali, head of endocrinology at PGI, says, “We have patients who are in need of pancreatic islets transplantation and we also have an expert team to perform the transplantation, but we are lacking in the number of donors.”