Advances in β-cell Replacement Therapy for the Treatment of Type 1 Diabetes

Overview

Journal Lancet

Publisher Elsevier

Specialty General Medicine

Date 2019 Sep 20

PMID 31533905

Citations 68

Authors

Marie-Christine Vantyghem

Eelco J P de Koning

Francois Pattou

Michael R Rickels

Affiliations

Soon will be listed here.

Abstract

The main goal of treatment for type 1 diabetes is to control glycaemia with insulin therapy to reduce disease complications. For some patients, technological approaches to insulin delivery are inadequate, and allogeneic islet transplantation is a safe alternative for those patients who have had severe hypoglycaemia complicated by impaired hypoglycaemia awareness or glycaemic lability, or who already receive immunosuppressive drugs for a kidney transplant. Since 2000, intrahepatic islet transplantation has proven efficacious in alleviating the burden of labile diabetes and preventing complications related to diabetes, whether or not a previous kidney transplant is present. Age, body-mass index, renal status, and cardiopulmonary status affect the choice between pancreas or islet transplantation. Access to transplantation is limited by the number of deceased donors and the necessity of immunosuppression. Future approaches might include alternative sources of islets (eg, xenogeneic tissue or human stem cells), extrahepatic sites of implantation (eg, omental, subcutaneous, or intramuscular), and induction of immune tolerance or encapsulation of islets.

Citing Articles

Spheroids Composed of Reaggregated Neonatal Porcine Islets and Human Endothelial Cells Accelerate Development of Normoglycemia in Diabetic Mice.

Honarpisheh M, Lei Y, Follenzi A, Cucci A, Olgasi C, Berishvili E Cells. 2025; 14(5).

PMID: 40072094 PMC: 11898817. DOI: 10.3390/cells14050366.

Pancreatic Ductal Cell Heterogeneity: Insights into the Potential for β-Cell Regeneration in Diabetes.

Britt M, Abdilmasih N, Rezanejad H Stem Cell Rev Rep. 2025; .

PMID: 40063303 DOI: 10.1007/s12015-025-10859-y.

Subcutaneous Implantation of Open Microwell Islet Delivery Devices in Pigs.

Tol M, de Vries R, Engelse M, Carlotti F, van Apeldoorn A, de Koning E Surg Innov. 2024; :15533506241306491.

PMID: 39670992 PMC: 11894865. DOI: 10.1177/15533506241306491.

Islet Transplantation: Current Limitations and Challenges for Successful Outcomes.

Langlois A, Pinget M, Kessler L, Bouzakri K Cells. 2024; 13(21.

PMID: 39513890 PMC: 11544954. DOI: 10.3390/cells13211783.

Pig Xenotransplantation in Beta Cell Replacement: Addressing Challenges and Harnessing Potential for Type 1 Diabetes Therapy.

Piemonti L, Citro A, Tomajer V, Partelli S, Caldara R Transpl Int. 2024; 37:13122.

PMID: 39512630 PMC: 11540633. DOI: 10.3389/ti.2024.13122.

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