Treatments for Diabetes

	Pancreas Transplants Self-Management Diabetes Research at the University of Minnesota

The pancreas contains islets (pronounced "eye-lets") and islets contain beta cells (like nesting dolls).  Beta cells are the only cells in the body that produce insulin.  Insulin is a hormone that allows cells to convert glucose to energy.  When food is consumed, beta cells release the precise amount of insulin needed over the correct period of time to convert carbohydrates and glucose into energy for use by the body.  Islets also contain alpha cells (which make glucagon, another hormone that affects the amount of glucose in the bloodstream) and delta cells (which make another hormone called somatostatin); however, but we focus on beta cells in diabetes research and treatment.

A person with diabetes has beta cells that are missing or deficient.  People with type 1 diabetes no longer have functioning beta cells; these cells have been mistakenly attacked and destroyed by their own immune system.  In order to survive, people with type 1 diabetes must take insulin shots, use an insulin pump, or replace their non-functioning beta cells by having a transplant. 

Since the discovery of insulin in 1922, people with diabetes have had the ability to inject insulin. Over the years, many new types of insulin and injectibles have been developed, allowing people with diabetes to tailor their diabetes management to their specific needs. Your physician and diabetes care team will help you determine the appropriate amount and type of insulin or injectible you need to effectively manage your blood glucose levels.

People with type 1 diabetes work with their diabetes care team to determine the number of shots, the type(s) of insulin, and the timing of the shots. It is important to find an insulin routine that keeps your blood sugar near normal and fits your lifestyle.  Studies have shown that 3 or 4 injections per day can improve blood sugar control and prevent or delay the eye, kidney, and nerve damage that diabetes can cause.

People with type 2 diabetes may need insulin injections or oral medications to lower their blood sugar. Some people with early type 2 diabetes can improve their blood sugar by exercising and/or losing weight. It is important to work with your diabetes care team to find a way to keep your blood sugar as close as possible to normal in order to prevent or delay the eye, kidney, and nerve damage that diabetes can cause.

Another method of treating diabetes is through beta cell replacement.  Replacing these cells with healthy transplanted ones restores the body's ability to produce insulin, and, for many people, has enabled them to reduce or eliminate the need for insulin shots. 

One method of replacing beta cells is a pancreas transplant (alone, or in conjunction with a kidney transplant), which has been a generally accepted standard of medical care for years.  Of the approximately 21,000 pancreas transplants performed throughout the world, about 15,000 have been done in the United States. The University of Minnesota has performed almost 1,700 pancreas transplants, over 10% of all transplants done in the United States. 

Another potential method of replacing beta cells is an islet transplant.  Islet transplants are still considered experimental.  The Diabetes Institute for Immunology and Transplantation (DIIT), within the Department of Surgery at the University of Minnesota, is one of the leading beta cell replacement centers in the world.