Diabetes treatment falls short

A few diabetics have been able to give up their daily insulin shots after getting transplants of pancreas cells, according to the broadest study of this experimental treatment. But for most patients, the results fell short of the cure researchers have been seeking.

Nearly half of the 36 patients who received the cell transplant achieved insulin independence by one year after the treatment. The benefits were mixed for the others, and about three-quarters of the whole group relapsed and needed insulin injections again.

The patients had severe cases of Type 1 diabetes, the less common form once known as juvenile diabetes, which is not linked to obesity.

Experts said the treatment, involving pancreas cells from donated cadavers, holds promise and they believe it won't be long before doctors figure out how to extend the benefit to more diabetics. Researchers, reporting their findings in Thursday's New England Journal of Medicine, said they did not know why it worked in some people and not others.

"For a select few, this represents a major alternative in their quality of life," said Dr. Robert Goldstein, chief scientific officer for the Juvenile Diabetes Research Foundation International.

The only way for diabetics to receive a pancreas cell transplant is to enroll in an experiment. The treatment is not yet available at U.S. hospitals.

About 5 percent to 10 percent of the world's 170 million diabetics have Type 1. The condition occurs when the pancreatic cells that make insulin, a hormone, are destroyed and can no longer produce it. The other form of diabetes, Type 2, is linked to obesity and occurs when the body can't properly use the insulin it makes.

Type 1 diabetics need regular insulin shots to survive. Insulin is required to convert sugar from food into energy. Although some patients have pancreas transplants, the procedure is often risky.

For years, doctors tried to perfect a less-invasive technique that involves transplanting pancreas cells from cadavers into patients. The procedure proved disappointing until 2000 when a group of Canadian researchers led by Dr. James Shapiro of the University of Alberta published a landmark study in the New England Journal that detailed a more efficient way to transplant cells into eight diabetics.

This latest study by Shapiro, which was partly funded by the U.S. government, is the first international and most extensive study of the treatment to date. It involved 36 Type 1 diabetics at nine hospitals in North America and Europe.