1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Pancreas transplants

Discussion in 'Alternative Treatments' started by TypeZero., Jun 20, 2020.

  1. TypeZero.

    TypeZero. · Well-Known Member

    Messages:
    296
    Likes Received:
    74
    Trophy Points:
    68
    Pancreas transplants are very rare and done only in extremely bad type 1s however there is a less invasive operation of transplanting pancreatic islets or more specifically injecting beta cells into the body.

    These beta cells can be derived from another person or can be artificially manufactured using human stem cells or skin cells dedifferentiated then differentiated into B cells.

    A transplant can last 7-14 years apparently effectively saving the NHS millions and reducing diabetes complications.

    So why won’t they do it? Why do they have to slowly kill us?
     
  2. Antje77

    Antje77 LADA · Moderator
    Staff Member

    Messages:
    11,619
    Likes Received:
    7,509
    Trophy Points:
    298
    As far as I know many people who have had this transplant still need exogenous insulin, so it's definitely not a cure all.
    You'd need to take immunosuppressants for life, which is heavy medication with nasty and dangerous side effects.
    We aren't slowly killed if we manage our blood glucose reasonably well. There are quite a lot of people who have lived with T1 for 50, 60, over 70 years, most of this time without the use of glucose meters, without the present sophisticated insulins and without CGM's or pumps.

    I'd much rather regulate my diabetes with insulin and food choices than having to deal with immunosuppressants, and I'm pretty confident that whatever will be the end of me, it won't be diabetes.
     
    • Like Like x 1
  3. Antje77

    Antje77 LADA · Moderator
    Staff Member

    Messages:
    11,619
    Likes Received:
    7,509
    Trophy Points:
    298
    Ah, thanks for the 'like', @Grant_Vicat !
    Was searching my brain for your name when I answered but it wouldn't pop up. No problem, as you've popped up yourself :D.
    @TypeZero. , Grant knows a lot about transplants and immunosuppressants, he's much better suited to answer your questions than I am.
     
    • Like Like x 1
  4. ert

    ert Type 1 · Well-Known Member

    Messages:
    2,371
    Likes Received:
    2,937
    Trophy Points:
    198
    Type 1 diabetes mellitus is the result of the autoimmune destruction of the insulin-producing beta-cells in the pancreatic islets. This would still happen with a transplant.
     
  5. KK123

    KK123 Type 1 · Well-Known Member

    Messages:
    3,916
    Likes Received:
    2,474
    Trophy Points:
    198
    Probably because that in itself is extremely high risk and only done if the benefits outweigh the risk? I'm not sure what you mean about them 'slowly killing us'?
     
  6. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

    Messages:
    15,704
    Likes Received:
    11,639
    Trophy Points:
    298
    Hi,

    I heard about this in the mid/late 1980s published in the "New scientist" from memory. (Old news on stem cell research?)
    I used to pick the mag up if there was something of interest. Either that or a Kerrang heavy metal mag? (But I digress.)

    Lol, before Internet. I did a little ringing round to put myself up for a crack at some "Guinea pig" work & thankfully, I got stone walled..?
     
  7. TypeZero.

    TypeZero. · Well-Known Member

    Messages:
    296
    Likes Received:
    74
    Trophy Points:
    68
    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
     
  8. Jaylee

    Jaylee Type 1 · Moderator
    Staff Member

    Messages:
    15,704
    Likes Received:
    11,639
    Trophy Points:
    298
    OK, the potentially "missing decade" is also old news.. (pre-tinternet.) As a 9/10 year old, I broke into a student nurse's room whilst she was out at a "disco" to do a little reading of her books? (My parents took in lodgers.)
    You get the info where you can...

    Regarding retinopathy; 44 years of T1 under my belt. To date, no retinopathy.

    Just throwing you a "bone" here as support from personal experience.. :)
     
    • Like Like x 3
  9. Grant_Vicat

    Grant_Vicat Don't have diabetes · Well-Known Member

    Messages:
    852
    Likes Received:
    1,156
    Trophy Points:
    178
    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.
     
  10. Grant_Vicat

    Grant_Vicat Don't have diabetes · Well-Known Member

    Messages:
    852
    Likes Received:
    1,156
    Trophy Points:
    178
    I trust you weren't hypo! Thanks for the alert.
     
    • Friendly Friendly x 1
  11. TypeZero.

    TypeZero. · Well-Known Member

    Messages:
    296
    Likes Received:
    74
    Trophy Points:
    68
    @Grant_Vicat

    It does sound horrible and undesirable to have a traditional pancreas transplant.

    Especially the tremor bit, I’m studying biology and simultaneously working at a GlaxoSmithKline laboratory on biopharmaceuticals and can’t imagine myself having hands so shaky that I can’t hold a pipette
     
    • Like Like x 1
  12. Grant_Vicat

    Grant_Vicat Don't have diabetes · Well-Known Member

    Messages:
    852
    Likes Received:
    1,156
    Trophy Points:
    178
    Ah, yes, they might confine you to er, tidying? Keep up vital work!
     
  13. kev-w

    kev-w Type 1 · Well-Known Member

    Messages:
    1,903
    Likes Received:
    3,156
    Trophy Points:
    178
    I know a T1 lass who's had the pancreas/kidney transplant, to the best of my knowledge 'they' prefer to do the op if the patient's kidneys fail as hers had done, she had the op around 6 (maybe more) years ago and is getting on with life although her foot and eye problems remained, no insulin but a number of blood tests and a good few anti suppressants and a re-admission or 2.

    Bright side is these days management is more simple due to better insulins, blood testing and CGM's and Libres for the lucky ones.
     
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook