A new method of combination stem cell transplantation could signify a new approach for treating patients with type 1 diabetes.
This research was led by Xiumin Xu, director of China-USA Collaborative Human Cell Transplant Program at the Diabetes Research Institute at the University of Miami, Florida.
In their study, they aimed to assess the safety and effects on insulin secretion of mesenchymal stromal cells (MSC) extracted from umbilical cords. MSCs are a type of adult stem cell that possess anti-inflammatory and potent immune-suppressing effects.
The researchers noted that MSCs have not been sufficient on their own to achieve the repair needed in type 1 diabetes patients, so they used autologous bone-marrow mononuclear (aBM-MNC) cells in addition.
Patients aged between 18 and 40 years with type 1 diabetes were recruited for transplantation between January 2009 and December 2010. They had daily insulin requirements of less than 100 units and HbA1c levels of 7.5-10.5 per cent (58.5-91.3 mmol/mol).
Following transplantatio, C-peptide secretion increased significantly in the stem cell transplant group. Decreased C-peptide levels are a well-known factor of type 1 diabetes, and in a control group who received standard care, an average 7.7 per cent decrease in C-peptide secretion was observed.
HbA1c levels dropped significantly at three, six, nine and 12 months in the cell transplant patients, but remained stable in the control group.
Patients who received stem cell transplants did not achieve insulin dependence, but experienced reduced insulin requirements of 29.2 per cent, on average. Insulin requirements remained unchanged in the control group.
None of the patients in the stem cell transplant group experienced any serious adverse events, and patient-reported severe hypoglycemia was also lower compared to the control group.
The findings of this study were published in the online journal Diabetes Care, and Diabetes Care editor William T Cefalu, MD, told Medscape Medical News: “This paper showed that interventions may show an effect even after many years of having established type 1 diabetes.
“It was a small study, but the fact that they were able to do this and show some benefit, particularly in those with type 1 diabetes for a little longer, was a step forward. More longer-term and larger studies will be needed at this time in order to fully evaluate the intervention as to efficacy.”

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