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Surgical Procedures for Type 1 Diabetes
Generally, type 1 diabetes is managed with insulin therapy, diet, and exercise. However, in some cases, transplant of the pancreas or islet cells might be an option.
A pancreas transplant may be done if you:
- Have developed severe renal disease especially if you may need a kidney transplant
- Have tried insulin treatment, but it has failed to prevent acute complications, like ketoacidosis
- Have severe emotional problems due to insulin treatment
- Have frequent, potentially life-threatening complications, particularly hypoglycemia
Kidney damage is a common complication of type 1 diabetes. Many people with diabetes end up with kidney failure that requires regular dialysis . In most cases, a pancreas transplant is done along with a kidney transplant. There is good evidence that quality of life significantly improves if these two transplants are done together.
Some doctors, though, do transplant only the pancreas. This is done in cases where the patient does not have kidney failure. Compared to pancreas-kidney transplant, the benefits of just a pancreas transplant are not as clear.
If you receive one or more transplanted organs, you will need to take immunosuppressive drugs for the rest of your life. These drugs prevent the immune system from attacking your new organ. However, these drugs have many severe side effects, including high blood pressure , hyperglycemia, hearing loss, nausea, gastric ulcers , and bacterial and viral infections. Some of these drugs may increase your blood sugar level.
Islet Cell Transplant
Islets are cells located in the pancreas. Only a small percentage of the pancreas is made of these islet cells, which include alpha cells that produce glucagon and beta cells that produce insulin. During the procedure , islet cells are taken from a donor and, using a catheter (small plastic tube), are transplanted to the blood of a person with type 1 diabetes.
This procedure is still being studied. Researchers have found that the beta cells are very fragile. Many of these cells may not survive long-term. In addition, the immunosuppressive drugs seem to impair the insulin-producing ability of the new cells and cause side effects.
There has been some promising research, though. For example, people who have had an islet cell transplant may have better blood sugar control, and some may even be able to stop their daily insulin injections.
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- Reviewer: Kim A. Carmichael, MD, FACP
- Review Date: 09/2014
- Update Date: 09/17/2014