Q & A Library

Actually, there is some exciting news from researchers seeking better ways to treat and, perhaps, ultimately, cure diabetes. Doctors in Canada have successfully transplanted donated islet cells - the cells that make insulin - into patients with type 1 (juvenile) diabetes, restoring their ability to produce insulin. In type 1 diabetes an autoimmune reaction destroys these islet cells, cutting off insulin production. The new technique is fairly straightforward: the cells are infused into the liver through a catheter. Once in place, they start producing insulin. This really works and seems to have cured some patients, but the first transplants were performed in 2000 so we don't yet know how long they will last. Some of the patients have required additional infusions. And of the 36 patients in the first group, the procedure did not work for six. Those who did benefit must take immunosuppressive drugs for the rest of their lives to prevent rejection of the transplanted cells.

Much work remains to be done before islet cell transplants become widely available. We need to know how long the transplants last and what the long-term effects of the immunosuppressive drugs will be. Another problem: a shortage of donated organs from which to extract the cells.

You may be aware that embryonic stem cell research could eventually yield a cure for type 1 diabetes. These cells have the ability to grow into other types of cells. This line of research focuses on turning stem cells into insulin-producing cells, which then could be implanted in diabetes patients, thus eliminating the need for injections. Unfortunately, the issue of stem cell research has become politically controversial although a recent Harris poll showed that Americans favor pursuit of this promising approach by a majority of more than six to one. If you wish to register your opinion, write to your representative in Congress, your Senators or to the White House. For information on efforts to persuade Congress and the President to fund embryonic stem-cell research, log on to the Juvenile Diabetes Research Foundation (www.jdrf.org ).

Andrew Weil, MD