Islet Cell Transplanation?

Islet Cell Transplantation at Walter Reed Army Medical Center
Sometimes, something good comes out of dangerous situations. We read with interest about a senior airman who was wounded in Afghanistan and then went through surgery to remove his pancreas. With transplantation of his own insulin-producing islet cells, he was able to function with no symptoms of type 1 diabetes.

The article can be found in the April 22, 2010, New England Journal of Medicine and was written by staff at Walter Reed Army Medical Center. Dr. Craig Shriver, Chief of general surgery at the hospital, consulted with Dr. Rahul Jindal, who suggested transplantation of islet cells when it became necessary to remove the pancreas.

They contacted Dr. Camillo Rocordi, who is chief of transplantation at the University of Miami Diabetes Research Institute, and he agreed to help. Within 24 hours, the harvested islet cells were infused back into the airman at Walter Reed and to date his blood glucose levels are normal.

Islet transplantation has not had as positive results with people who have type 1 diabetes, as the process of beta cell destruction continues after the transplantation. This surgery, however, has given new hope that as the surgery improves, new treatments will become available using small sections of pancreas which can be saved.

Read more about this story here.

How Diabetes Affects Teenagers and Family Relationships
In the April 7, 2010, issue of the Journal of Adolescent Health, there was an article written by Korey Hood, PhD et al from the University of Cincinnati College of Medicine and Cincinnati Children’s Hospital. The article was called “Blood Glucose Monitoring and Glycemic Control in Adolescence: Contribution of Diabetes-specific Responsibility and Family Conflict.”

The researchers followed 147 adolescents for 6 months and found that areas and levels of conflict between teens and parents remained rather static during this time period. They did find, however, that younger teens who started to take more responsibility for their own care and who also had conflict with parents over this issue had a significant rise in their hemoglobin A1c levels.

This usually happens in late adolescence and young adulthood, and then it starts to decline as they take more appropriate responsibility for their diabetes care. This article once again points out the relationship between normal developmental stresses and the added burden of having a chronic disease like diabetes.

Read the abstract of this study.

Type 2 Diabetes and Exercise
Helping people understand diabetes and the need to modify lifestyle is a difficult task. The May 2010 Diabetes Research and Clinical Practice has an article titled “Prescription of physical activity is not sufficient to change sedentary behavior and improve glycemic control in type 2 diabetes patients.” It’s by Willeke Wisse et al, and it underscores the difficulty in changing the attitudes and lifestyles of these patients.

For 2 years, the researchers followed a group of 74 sedentary type 2 diabetes patients taking insulin to assess the value of an individualized exercise program.

The participants were divided into 2 groups, one of which was given an intervention which included regular structured exercise and individual physical therapy sessions.

The results were not promising. During the 2 year program, the level of activity during leisure time did not change. There were also no changes in blood glucose level control or weight and body composition. The researchers concluded that an individual plan for exercise was not sufficient to change behaviors for sedentary type 2 diabetics.

What the researchers did not say was why it is so difficult to motivate and change sedentary individuals and what would motivate them. Obviously, more research is needed.

Read the abstract of the study.

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