Can Type 1 Diabetes be cured?

This is a common question we get in clinic, and from random interested folks out in the community. And I KNOW many of you in Vincyland may have asked his question too, so here is the answer: Yes, but it is complicated.{{more}}

As we have discussed, Type 1 diabetes is a result of lack of insulin in the body, most often from destruction of the cells in the pancreas that normally make insulin. Once those cells have been destroyed, they do not grow back, and so a person needs insulin replaced through medications. This is where the potential cures for Type 1 diabetes come in, and you will fast see why I describe them as “complicated.”

Before I tell you the answers, I should let you know what I mean by “cure”. By saying this, I mean that a person who was formerly totally dependent on insulin, would no longer need insulin as a medication to control blood sugars (blood sugars would all be normal without needing any medications to do so). Anything short of this is not considered a “cure.”

Both known cures for Type 1 diabetes (that we have available right now in medicine) involve surgery to replace those cells in the pancreas that make insulin – they are called pancreatic Islet cells. These are the only cells in the body that make insulin. One surgery involves giving a person a bunch of those cells. It is called an Islet Cell Transplant. This may sound straightforward to you – those cells are dead, so just replace them, right? Unfortunately, this procedure, which years ago was hoped to truly be an end to Type 1 diabetes, has not quite turned out as successful as we had hoped. Any transplant of cells that are not yours will have potential problems with what we call “rejection”, which is where your body recognizes that those cells are not its own, and basically reacts against them. There are also other issues and complications related to the process and procedure of transplanting the Islet cells.

The second known cure is similar, but involves replacing the ENTIRE gland that produces insulin – it is a pancreatic transplant. This is also of course a major surgery. Often pancreatic transplant is reserved for patients who have extremely “brittle” diabetes, with frequent highs and lows, and who have failed all conventional treatments available. This, though complicated, may also sound like an easy choice and solution. But besides the issues with surgery itself and related complications, in both cases of pancreatic and islet cell transplant there are concerns with possible rejection. People who undergo these procedures need to take lifelong medications called anti-rejection medications, in order to save those transplanted cells and organs from being destroyed by their new body.

So, yes, there are available cures for Type 1 diabetes. However, as you can see, they are not simple. There are many, many researchers working on finding a cure for Type 1 diabetes. But until that blessed day when a cure is found, and one that is readily available to all, we will continue to try to do what is best for right now: diagnose it early, start on insulin treatment, and get control quickly.

Until next week, stay safe and healthy Vincy family!

Anita Ramsetty, MD endodocs@endocrinehelp.com

Medical Director Endocrine Care Group

www.endocrinehelp.com

Tel: 843-798-4227