Patients with diabetes insulin-free for years after islet transplantation

Many people with type 1 diabetes live in fear of their blood sugar levels suddenly getting too low. If untreated, this hypoglycemia can cause confusion, loss of consciousness and even death.

While most diabetics can control their glucose levels with insulin, some are considered “brittle” – their glucose levels can swing wildly, often dropping without the usual warning signs of shakiness or sweating.

Ten years ago, Mark Morrison, who has had diabetes since he was 16, couldn’t feel his lows coming on. Hypoglycemia caused him to crash his car twice. In one accident, he hit a tree and broke his sternum. In the other crash, his car caught fire.

“I could eat the same food, have the same amount of activity, and take the same insulin each day, and one day I would have high blood sugar, and then another day I would have low blood sugar,” said Morrison, who is now 64.

Mallory Kon, diagnosed with diabetes when she was 5, found that as an adult, her blood sugar would go from normal to dangerously low within an hour. Sometimes, her glucose levels would get so low that she would fall asleep without realizing it. “I was not feeling my lows anymore,” she said, “which was really scary.”

Today, Morrison has been off insulin for 9 years after enrolling in a clinical trial at the University of Chicago Medicine to receive an innovative procedure: an islet transplant. Islets, clusters of cells in the pancreas, contain several types of cells, including beta cells that produce insulin. In type 1 diabetes, a person’s own immune system destroys those beta cells, causing diabetics to need daily insulin to control their glucose levels.

An islet transplant transfers donor islets into a diabetic patient’s body. Through the procedure, surgeons infuse donor islets via a small catheter into a patient’s liver without the need for surgery. The beta cells within the islets then begin to produce insulin, and act as a pancreas. Currently, as with any organ transplants, patients still must take anti-rejection medications after the procedure.

Morrison had the transplant in November 2013, and just three weeks later, he was completely off insulin. “I could have Thanksgiving dinner and not worry about how much insulin I needed, and I’ve been off insulin ever since,” he said. “It has been such a blessing for me. I feel so fortunate this happened.”

Most Active Center Offering Islet Transplants

Since 2005, surgeons at UChicago Medicine, led by transplant surgeon Piotr Witkowski, MD, have performed 79 islet transplants— including 11 transplants this year. This makes UChicago the most active center islet transplant center of the three currently offering the procedure in the U.S. “The high cost covered only by research funding limits the number of transplants and patient access to this leading-edge therapy,” Witkowski said.

“These patients often live in constant fear of dying,” Witkowski added. “This procedure is less invasive than a pancreas transplant and could potentially help hundreds of the most desperate, out of over 1.5 million patients with type 1 diabetes in the U.S.”

Though the procedure has been approved in several countries in Europe as well as in Canada and Australia, it is still considered experimental in the United States. In contrast to other countries, the FDA classifies islets as a biologic drug, not as a tissue or organ for transplant, and has not given islet transplantation full approval.

Witkowski performs the procedure in clinical trials and continues to work on getting approval so any patient who is eligible could receive the therapy. He recently published a