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A new study found that individuals with type 1 diabetes need fewer insulin shots while using an experimental gadget containing millions of stem cells. Researchers believe this treatment could eventually lead to a cure for the chronic, life-altering illness.

The University of British Columbia and Vancouver Coastal Health researchers employed VC-02, which are microscopic implants loaded with cultured pancreatic cells.

Ten participants in the study, which was first reported in the journal Nature Biotechnology, were unable to naturally manufacture insulin at the beginning of the trial. Three of them saw significant improvement after six months with the implant. They required less insulin because their bodies were in the normal blood sugar range for longer periods of time.

The hope is to get these cells strong enough to help stop requiring insulin injections all together,” said David Thompson, MD, principal investigator at the Vancouver trial site and clinical director of the Vancouver General Hospital Diabetes Centre. “I believe this is going to turn into a cure as soon as 2024.”

In people with type 1 diabetes, the immune system attacks and kills beta cells, which are responsible for producing insulin in the pancreas. One hormone that controls blood sugar levels is insulin. The illness, also known as juvenile diabetes, is typically identified in the early stages of puberty, between the ages of 4 and 6.

Type 1 diabetes affects males and women at almost equal rates, with non-Hispanic White persons being the most likely to have it in the United States. The likelihood is increased if a close relative has the disease. In the US, 1.24 million people have type 1 diabetes; by 2050, that figure is predicted to rise to 5 million.

It seems as though the body’s insulin factory has shut down in those with type 1 diabetes. Insulin must be taken from the beginning by those who have the condition.

This is not the same as type 2 diabetes, where the body mishandles insulin. It can be controlled with medication, dietary adjustments, and occasionally exogenous insulin injections.

Diabetes was fatal up until the discovery of insulin a century ago. The first patient of the new treatment was a 14-year-old boy who lay dying in a Toronto hospital from diabetes in 1922. His elevated blood glucose levels returned to almost normal levels in less than a day.

“Insulin therapy for people with type 1 diabetes is better than it has ever been, but it’s still not a cure,” Thompson said. “This is probably the first wave of a new era of medicine using cell therapy.”

ViaCyte, a biotechnology company, created an experimental cell treatment that was evaluated in this trial.

The gadgets that Thompson and his colleagues utilized were tiny bandage-sized implants that were placed just beneath the skin. In contrast to a glucose monitor, which is likewise placed under the skin but only measures blood glucose, the stem cell device provides the body with a continuous flow of insulin.

The experiment expands on a 2021 study that suggested this strategy might aid in the body’s production of insulin. In order to increase the survival rate of the lab-grown cells, the most recent study modified the design and increased the number of devices per person.

Beginning with no insulin production at all, each participant in the trial underwent surgery at locations in Vancouver, Belgium, and the United States to get up to ten device implants. Three of them had evident symptoms of insulin synthesis after six months, and these indicators persisted for the entire year of the trial. One trial participant had a significant improvement, using 44% less additional daily insulin and spending more time in the target blood sugar range.

“Each device is like a miniature insulin-producing factory,” said co-author Timothy Kieffer, PhD, a professor with the departments of surgery and cellular and physiological sciences at the University of British Columbia, and past chief scientific officer of ViaCyte. The cells are “packaged into the device to essentially re-create the blood sugar-regulating functions of a healthy pancreas.”

A cure for type 1 diabetes would also mean averting a number of other health issues associated with the disease, such as kidney issues, limb loss, blindness, and even potentially fatal blood sugar decreases while you sleep. Additionally, diabetes dramatically increases the risk of a heart attack or stroke.

Robert Gabbay, MD, chief scientific and medical officer of the American Diabetes Association, who was not involved in the experiment, stated that there are two significant limitations to the study. Not only is it tiny, but the technology fell short of the intended goal of normalizing blood glucose levels.

However, he argued, it shows promise. A significant obstacle has traditionally prevented cell replacement therapies: the immune system assaults the implanted cells, necessitating the use of potentially hazardous immunosuppressive medications.

“This is particularly problematic for people with type I diabetes since the initial cause of type 1 is an autoimmune destruction of beta cells,” Gabbay said. “Placing beta cells sequestered from the immune system has been something that a number of investigative teams have worked on. This early study shows some proof of concept.”

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