People with Type 1 diabetes cannot produce the hormone insulin which means that they need to rely on daily injections of insulin in order to stay alive. Insulin is created by specialised cells in the pancreas called the islets of Langerhans.
When blood glucose levels go up, insulin is secreted to bring them down again by allowing the glucose to be taken up by the muscle and other organs in the body that need it for energy.
In many countries, islet cell transplantation is now considered a viable treatment for type 1 diabetes. The procedure involves extracting islet cells from the pancreas of a deceased donor and implanting them in the liver of someone with type 1 diabetes. Here, a blood supply is established and very shortly after the procedure, the new islets will start to produce insulin in response to glucose. At this time, the transplant patient will become aware that their blood glucose levels are easier to manage.
To encourage the availability of this procedure to people living with the condition, in 2004, the Diabetes Research and Wellness Foundation (DRWF) made an unprecedented grant to the Nuffield Department of Surgery at the Radcliffe Hospital, Oxford, to help to establish the Human Islet Isolation Facility at the Oxford Centre for Diabetes, Endocrinology and Metabolism in Oxfords’ Churchill Hospital. The facility was launched in 2006 and it harvests human islets from donor pancreases for research purposes as well as for transplant.
As with other transplantation operations, the transplant patient must take anti-rejection drugs to make sure that their immune system does not reject the newly transplanted islet cells. These drugs must be taken for the rest of the transplant patient’s life and have known side-effects. But, for some people with type 1 diabetes, this potential risk is worth taking. Rae-Marie Lawson is a Trustee at the DRWF. After 25 years with type 1 diabetes, she was offered an islet cell transplant at the Oxford facility. ‘It has changed the way that I live my life’ she says. ‘I have been insulin independent for five years now. I no longer need to take the daily insulin injections that I had to before the operation and the success of the procedure means that I don’t have that constant worry about my blood sugar levels any more’
