A pioneering medical procedure has enabled a 25-year-old woman with type 1 diabetes to produce her own insulin after receiving a transplant of reprogrammed stem cells derived from her own body. 

Conducted by cell biologist Deng Hongkui and his team at Peking University, this is the first instance of treating type 1 diabetes using patient-specific cells. The researchers extracted cells from the woman and reprogrammed them into induced pluripotent stem (iPS) cells using small molecules—a modification of Shinya Yamanaka’s technique—which offers more control over the reprogramming process. 

These iPS cells were then differentiated into three-dimensional clusters of insulin-producing islets.
“I can eat sugar now,” said the woman on a call with the journal Nature. “I enjoy eating everything — especially hotpot.”

In June 2023, approximately 1.5 million of these islet clusters were transplanted into the woman’s abdominal muscles, a novel site that allows for monitoring via magnetic resonance imaging and potential removal if necessary. Remarkably, within two and a half months, she began producing sufficient insulin independently and has maintained stable blood glucose levels for over a year. 

While she was already on immunosuppressants due to a prior liver transplant—which precluded assessment of the graft rejection risk—the success suggests a promising avenue for treating type 1 diabetes.

This approach could potentially eliminate the need for donor islets and immunosuppressive drugs, addressing the limitations of current islet transplantation therapies that suffer from donor scarcity and immune rejection issues.

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However, the method’s scalability and commercialization pose challenges, prompting other groups to explore using donor stem cells. For instance, Vertex Pharmaceuticals is conducting trials with islet cells derived from donated embryonic stem cells, with some participants achieving insulin independence after transplantation while receiving immunosuppressants.

The success of this personalized stem cell therapy marks a significant advancement in diabetes treatment, but experts caution that further replication in more patients and long-term monitoring are necessary before considering it a cure. Ongoing research aims to expand trials to more individuals and to develop cells that can evade autoimmune responses without the need for immunosuppression, potentially making the therapy more widely applicable.

Per Nature,

James Shapiro, a transplant surgeon and researcher at the University of Alberta in Edmonton, Canada, says the results of the surgery are stunning. “They’ve completely reversed diabetes in the patient, who was requiring substantial amounts of insulin beforehand.”

Type 1 diabetes is a chronic autoimmune disease characterized by the destruction of insulin-producing beta cells in the pancreas. This leads to an absolute deficiency of insulin, a hormone crucial for regulating blood glucose levels by facilitating the entry of glucose into cells for energy production. Without sufficient insulin, blood sugar levels rise, resulting in hyperglycemia and associated complications such as cardiovascular disease, nerve damage, and kidney failure. The condition typically manifests in childhood or adolescence but can occur at any age.

According to the International Diabetes Federation, as of 2021, approximately 8.7 million people worldwide are living with type 1 diabetes. Management of the disease requires lifelong insulin therapy, regular blood glucose monitoring, and lifestyle adjustments to maintain stable blood sugar levels.