Diabetes Essay, Research Paper

Steve Callians

Phil Mcgawaan

English 102

Sep. 3, 2000

DIABETES

In 1921, Canadian researchers isolated insulin from dog pancreases and discovered that the hormone is essential to controlling blood sugar. Given by injection, insulin reversed wasting in diabetic children and extended their lives. Dramatic as its effects are, however, insulin isn’t a cure for diabetes. People with the disorder must monitor their blood sugar closely and take insulin injections to reduce the risk of nerve damage and heart, kidney, and eye disease. In a small percentage of these people, insulin injections fail to keep blood-sugar concentrations from fluctuating wildly. Scientists and patients agree that the ideal diabetes treatment would control patients’ blood-sugar concentrations without requiring them to take insulin. One long-sought option is transplantation of pancreatic cell clusters, called islets, that make insulin. Though the approach is simple, it has succeeded in only a small fraction of the attempts.

This year, however, a Canadian team announced 11 consecutive successes–islet transplants that permitted the recipients to stop taking insulin. Although there are still questions about the long-term safety and efficacy of this treatment, there’s a sense of excitement among researchers. In Toronto at the June meeting of the Endocrine Society, David M. Harlan of the National Institutes of Health in Bethesda noted, “Islet-cell transplantation, which has long been promising, appears poised to fulfill its promise.” Affecting 1 million people in the United States, type I diabetes arises when a patient’s immune system attacks the insulin-producing cells in the pancreas. While a pancreas transplant effectively cures the diabetes in most cases, the procedure is difficult and expensive and few donor pancreases are available.

Physicians can transplant just the insulin-producing cells in a less taxing process that doesn’t require major surgery. For the past 25 years, they’ve tested procedures in which they inject the cells into the major blood vessel flowing to the liver. The cells can take up residence there. After the procedure, patients must take immunosuppressive drugs. Overall, just 8 percent of people given islet-cell transplants have improved their ability to control blood-sugar concentration enough to stop taking insulin.

They concerns and problems that they have been dealing with in the past are those of the transplant wiping out your immune system or even blowing your diabetes out of proportion and making the diabetic very sick. The case with the immune system wiping out would have the same similarities as someone with the disease, AIDS. This is the first study that allows the diabetic the ability to not be on insulin and not have to take pills to help the immune system.

Pig islets–which produce insulin that’s almost identical to human insulin–can be genetically engineered to express human proteins. To further reduce the risk of a person’s immune system rejecting the islets as foreign, physicians might transplant pig islets enclosed in a capsule that permits insulin to seep out but blocks immune cells from attacking the foreign tissue. Although pig islets work wonders in rodents there are still some studies needed to be done to be able to comfortably use these in humans.

Right now studies are showing that the islet transplants are working, and researchers will continue to work hard on cracking this cure. They are projecting that they will start trying these transplants on those diabetics with extremely bad cases. Doctors feel that even if the transplants start to wear off in the future, that doesn t mean death, it will just mean that they will have to be put back on insulin again. Hopefully within the next 5 years or so, diabetes will no longer be a problem and this will be accepted as the cure. Myself, a diabetic since the age of five, feels that this is a wonderful development. Throughout the 16 years I have had this disease, they have never been this close to curing it. I feel that they are on to something very special here and in time will find the cure that all the other diabetics in this world and I have been waiting for quite some time.