I understand that technology has progressed but it is not available for everyone due to costs from self-funding and eligibility criteria from public funding. It’s great to hear about these amazing systems such as a closed loop system pairing a Dexcom G6 with a Medtronic 640g insulin pump to create an artificial pancreas but how many people are using this...? Only a small percentage. The reality is diabetes is hard to manage, even if you go very low carb. Sometimes you crash suddenly for no reason at all and sometimes you shoot up without even eating anything. In the end statistics suggest at least more than a decade being cut off your lifespan.
I do understand the complications with transplants but I’ve done research and you can have B cells tailored for you. There is some research about using your own skin cells and stimulating them with different reagents to differentiate them into B cells. These B cells would have the same antigens as your skin cells so your body shouldn’t hopefully attack it.
Even if a pancreas or islet transplant doesn’t cure you completely for a period of time it will help you out and imagine having 7-14 years of more time in range, less hyperglycaemic episodes. The current most widely available form of transplant does involve immunosuppressants but surely it has got to be better than all sorts of complications. If I don’t remember incorrectly most T1Ds develop retinopathy within 5 years of diagnosis
Hi @TypeZero and thanks to
@Antje77 for the tag! Many diabetics consider pancreas transplant must be the answer to all their problems. I think the reality is that it is a last resort brought about by serious diabetic complications. If I take a broad overview of my Type 1 life, the first stage (1959-1966) was primitively controlled by one daily injection of Lente (slow acting insulin). This stopped being effective just after my 8th birthday, causing a five day coma. I was therefore put on a mixture of Monotard and Rapitard twice daily (slow and fast acting) and from 1966-1979 I had already started to show signs of nephropathy (1973) and retinopathy (possibly beginning in 1971, but testing didn't occur till I went to King's College Hospital (1978-2000). In that time I was visiting outpatients at least monthly if not more frequently because of kidney function. I was put on Irbesartan and Indapamide and was so terrified of what the likely outcome would be that I was very strict with my regime, regularly managing near normal HbA1c results. It was this that slowed down nephropathy considerably. In the period 2000 - 2013, it was being closely monitored by Addenbrooke's Hospital Cambridge, and in 2012 I was put on the transplant list. By August 2013 it was arranged for me to undergo peritoneal dialysis on 22/8/2013. By some incredible piece of luck I was called in (7th attempt) for the transplant, which took place 13th-14th August. There had been several hiccups, caused usually by gout or cellulitis, which suspended me off the list. I also had to undergo several tests to see whether I was fit enough to be operated on. One of the main tests was called a MIBI scan, which puts your heart under stress (by injecting Adenosine) and images can be taken of a radioactive substance called Sestamibi. I also had to walk on a treadmill for twelve minutes.
In spite of my diabetic condition over those years, for 18 of them (1995-2013) I was chosen for every sports match at the school where I work. This undoubtedly helped prepare me for what is a highly risky operation. Since 14/08/2013, I have been on Tacrolimus and Mycophenolate (5 and 4 per day respectively) which cause tremors, especially in my hands. Being an organist, pianist and artist I am somewhat challenged nowadays! Also, I find it impossible to hold a teaspoon of say coffee without spilling it everywhere except where it's intended. Much more crockery and glass has been broken in the last six years than in the prevoius twenty! Also I have had one serious scare during this time. On 13/08/2018 the level of Lipase and Amylase in my blood was three times the acceptable level. Most likely my pancreas was being slowly rejected. By 7/02/2019, Addenbrooke's had got it back within the safe level having doubled my dose of Mycophenolate. Were they to increase the Tacrolimus, it would cause kidney damage!! I also realise that if I live sensibly I could make it to 75, but I have never seen the point of living anything else but for the moment. Finally I have had fewer than 5 flu jabs in my life. The last time I had one I contracted Swine Flu. This sounds highly irresponsible, but my immune system (don't forget this was powerful enough to destroy my islets when I was 11 months old) is incredibly strong. The immunosuppressants have knocked out the vanguard, but the rearguard stops me being laid out by bugs which run through school regularly. Nevertheless I am still shielded.
You might find the following link helpful:
https://academic.oup.com/bmb/article/124/1/171/4568432
Bear in mind that the goalposts have moved dramatically since my childhood and adolescent days. A diabetes doctor who retired in 1982 told me that they didn't really know what they were doing some of the time, but were just glad to keep patients alive. Regardless of medical trends and diet fashions, care is much more sophisticated now. I wish you well.
