What is diabetes mellitus and how can stem cells be used?

The global incidence of diabetes mellitus has increased dramatically over the past few years and continues to rise. The quest for curative therapies, that normalize blood sugar levels and provide independence from exogenous insulin therapies, impacts patients with type 1 and type 2 diabetes. As a source of insulin producing cells, stem cells help us understand the disease better and hold tremendous potential for treatment. Researchers are looking for ways to diagnose people earlier, prevent their diabetes from getting worse, and to more effectively treat the disease.

The Stem Cells Transplant Institute in Costa Rica is a pioneer in stem cells therapies. The experts at the Stem Cells Transplant Institute treat patients from all over the world, including patients from the United States and Canada, where stem cell therapies are not yet FDA approved. We want our patients to be informed about the latest news involving this innovating treatment. We believe the limited treatment options available today for many diseases, like diabetes, is evolving and soon there will be a new world of opportunities for patients.

Diabetes mellitus is a chronic, debilitating disease, in which the body either cannot properly use the insulin it produces or cannot produce insulin at all. Insulin is a hormone that controls the amount of sugar in the blood. Diabetes leads to high blood sugar levels, which can damage organs, blood vessels and nerves. The body needs insulin to use sugar as an energy source.

The pancreas is an organ that sits behind the stomach and releases hormones into the digestive system. In the healthy body, when blood sugar levels get high, beta cells (special cells in the pancreas) release insulin, a hormone that causes muscle cells to take in sugar to use as energy or to store as fat. This causes the blood sugar level to return to normal.

Having high blood sugar can cause diabetes-related complications, like chronic kidney disease, eye disease (retinopathy) that can lead to blindness, heart attack, stroke, foot problems, amputation, anxiety, nerve damage, and erectile dysfunction.

Stem cells are being used to create new cell cultures in diabetic animal models that better reflect what happens in a human. There is great interest in developing strategies to expand the population of functional beta-cells. Possible ways to achieve this include physically replacing the b-cell mass via transplantation, increasing b-cell replication, decreasing b-cell death, and deriving new b-cells from appropriate progenitor cells (stem cells).

By the end of the 1990’s, many transplants had been reported using islets from the cadaveric pancreatic tissue of multiple donors and infusing them into the recipient’s portal vein. However, the lack of available appropriate donor tissue and the exhausting regimen of immunosuppressive drugs necessary to keep the body from rejecting the transplanted tissue limited the widespread use of this approach.

These challenges have led researchers to explore the use of stem cells as a therapeutic option. Type 1 diabetes is an ideal candidate disease for stem cell therapy, as the causative damage is localized to a particular cell type. In theory, stem cells that can differentiate into beta-cells could be introduced into the body, where they would migrate to the damaged tissue and differentiate as necessary to maintain the appropriate b-cell mass.

There are also some methods in development that can coax stem cells grown in the laboratory to differentiate into insulin-producing b-cells that could be transplanted into a patient. Stem cell therapy would directly benefit persons with type 1 diabetes by replenishing b-cells that are destroyed by autoimmune processes, although it would still be necessary to reduce the autoimmune destruction of beta-cells.

Researchers are making beta cells from induced pluripotent stem cells, which can be grown in large numbers in the laboratory. Recent advances in these technologies make this a very promising avenue for generating large numbers of replacement beta cells.

Beta cells can make copies of themselves in the pancreas, but usually very slowly, and less and less as we get older. Researchers are looking for drugs that might enhance this self-renewal as a possible treatment for people with type 2 or early-stage type 1 diabetes.

The key to these approaches is getting beta cells into parts of the body where the replacement cells are less likely to be attacked by the immune system or placement of the cells into protective capsules that are porous and would allow small molecules such as glucose and insulin to pass through, while protecting the beta cells from the cells of the immune system.

Developing and testing a truly effective stem cell based treatment for diabetes is still in process. Researchers are looking at ways to restore the number of functional beta cells in patients with diabetes, pursuing both the replacement of lost beta cells and the protection of beta cells from further damage. The studies made so far are very promising and many clinical trials are being applied for under patient´s consent. At the Stem Cells Transplant Institute in Costa Rica, we look forward to being a platform for our patients to get into these innovative therapies and improve their quality of life. Contact us for more information.