August 2007 - A new drug is showing great promise in returning patients with type 1 diabetes to insulin independence. Diabetes researchers at the University of Miami Miller School of Medicine were able to re-establish long term insulin independence in diabetes patients who underwent a supplemental islet cell infusion while being treated with exenatide at the same time. The late-breaking findings were presented during the 67th scientific sessions of the American Diabetes Association.
Patients at UM's Diabetes Research Institute received exenatide, which is a drug used to treat type 2 diabetes, for at least three months and continued to receive it after the supplemental islet infusion. Exenatide is the first in a new class of medicines known as incretin mimetics which reduce blood sugar levels and improve islet function.
"Our research suggests that supplemental islet infusions during treatment with exenatide are more successful in achieving and maintaining insulin independence," said Raquel Faradji, M.D., lead author of the study and assistant director of the clinical islet transplant program at the Diabetes Research Institute. "This may be due to improved islet function and perhaps an increase in the amount of islets. Given the shortage of donor pancreases, exenatide may help achieve and maintain insulin independence in more islet transplant recipients using only one donor pancreas."
Transplants using islet cells are currently considered the most promising method for curing diabetes. During the procedure islets are separated from a donor pancreas and infused into the liver of a patient with diabetes. In the liver, within a short time, they begin to produce insulin.
The four patients who underwent the supplemental islet infusion in 2006 while taking exenatide were compared to a control group of five patients who underwent a supplemental infusion without the drug treatment. Only one patient without the drug treatment remained insulin independent after one year, while all the patients in the drug-treated group were insulin independent at one year.
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"All of the patients had achieved insulin independence after their initial islet cell transplants, but eventually developed graft dysfunction and had to go back on insulin," said Faradji. "To be able to re-establish insulin independence with a supplemental infusion is a big step forward, and we now need a larger trial to see if using exenatide is making the difference."
Source: University of Miami Miller School of Medicine