Treatment of Diabetes Mellitus
Although Diabetes mellitus is a life-long disease, there are recent techniques for the treatment of diabetes mellitus. It is a condition of high levels of sugar in the blood. It has several types but there are two main types which are type 1 and type 2.
In early times, treatment and management focus on using drugs and insulin to decrease the levels of sugar in the blood. This means that they focus on adapting the case and keeping the levels stable.
In recent times, the medical field is in continuous development. There are new methods such as organ transplantation, medical operations, devices, and tools.
The new techniques include:
- Islet cell transplantation.
- Pancreas transplantation.
- Insulin pump.
- Other techniques.
Islet Cells Transplantation
Islet cell is a type of cell that is in our pancreas. It is responsible for insulin synthesis and release. Also, it is called the Islets of Langerhans.
What is this method? And who can benefit from it?
Transplantation is the introduction of cells, organs, etc… into the body or under the skin. In this method, doctors take healthy cells from the dead donors and transplant it into the patient’s pancreas. This method is still under investigation and clinical trials and under the supervision of the Food and drug administration organization (FDA). Clinical trials have started since 1995.
This method is useful if you are a type 1 patient. In type 1 the immunity abnormally attacks the pancreas islet cells and destroys them. It is for patients who are difficult to manage their blood sugar either the levels are high or low.
Pros of Islet Cells Transplantation
Dr/Shareen Forbes and Dr/Richard Oram are expert United kingdom doctors who say that this method has plenty of advantages to type 1 patient. These advantages include:
- Improvement and management of blood sugar levels.
- limited or no suffering of low blood sugar levels, which is can occur if you are a patient of diabetes or not.
- The ability to recognize if there are low levels of sugar in the blood.
- You will decrease the need for insulin injection or you won’t need it at all.
- Improvement and avoidance of secondary damage to the kidneys, eyes, nerves, and heart.
Cons of Islet Cells Transplantation
The disadvantages are major and minor. They include:
- The pain associated with the transplantation.
- The method requires repetition in order to succeed and show promising results.
Normally, our immunity tends to resist and refuse any foreign cells, organs, and bodies. So there is always a worry that the recipient patient’s body may refuse and not respond to the donor cells.
- In any transplantation, doctors use an immunosuppressant. An immunosuppressant is a drug which decreases the immunity response in order to decrease the immunity attack on the new cells and organs.
The use of immunosuppressants has its drawbacks that include:
- The decrease in immunity response makes the patient a target to infections, The infection is sometimes dangerous and is life-threatening.
- Suppressing immunity makes the patient vulnerable to cancer.
- The patient’s body becomes weak and he/she is fatigue.
- It is difficult to find healthy donor cells.
- The method is expensive.
Another application of this method include:
Patients who have inflammation in their pancreas or in the case of doctors had removed the pancreas due to medical causes. This application doesn’t require the use of drugs to suppress immunity because they use the patient’s own cells. They already use this method for this purpose and it is not under investigation.
Different techniques of islet transplantation include:
- Introducing the cells into your liver.
- Introducing the cells under your skin.
- Capsulating the cells to decrease the resistance of the immunity.
- Capsulating and filtering the cells. The importance of filtration lay in removing the empty capsules that aim to decrease the amount of capsules injection.
- Generating the cells from the stem cells of the patient himself/herself. Stem cells are a very important type of cell in our body, they are the beginning of all cells in our body.
Transplantation of the Pancreas
The pancreas is one of our body organs that doctors can replace due to different conditions and diseases that damage the pancreas such as severe inflammation, viral infection, accidents, etc…
To focus on our subject we will talk about pancreas transplantation and the management and treatment of diabetes. Pancreas transplantation includes:
- Transplantation of the kidney and the pancreas together.
- The transplantation of the kidney followed by the pancreas.
- The transplantation of the pancreas alone.
The replacement of the pancreas is useful for a type 1 patient. The replacement includes three ways:
- Taking the pancreas from a dead donor and giving it to the patient.
- An artificial pancreas. The doctor places it outside the body and it mimics the pancreas and responds to the sugar levels in the blood. It is not transplantation but the more accurate description is an artificial replacement of the pancreas.
- Using the patient’s stem cells.
Pros of Pancreatic Transplantation
In case your body accepted the new pancreas, the advantages of this method include:
- The control and management of type 1 diabetes and late-stage type 2 patients.
- The control and management of the episodes of low levels of sugar in the blood.
- After the transplantation, you will require less insulin and gradually you may not require any insulin at all.
This method has the benefit of providing both Insulin and Glucagon. This will balance the levels of sugar by the presence of both hormones in case of type 1 patient who has a defect in the production of both hormones.
Cons of Pancreatic Transplantation
The disadvantages of this method are mainly due to the suitability of the donor organ with the patient’s body and the use of immunosuppressants.
The cons include:
- The rejection of the patient’s body to the donor’s organ.
- Multiple infections.
- Fatal infections.
- If your body accepts the organ that is actually very good. However, there is a worry that the organ is adapted to the body, start functioning or not functioning with the required minimum capacity.
- Blood clot including clots that reaches the lungs.
- The method is expensive.
In transplantation reports in June 2019, there is interesting research that studies a group of patients who have diabetes and kidney disease. This study shows promising results of simultaneous pancreas-kidney transplantations but there are the obstacles of organ rejection and the requirement of additional medical procedures to reduce this rejection.
In the International Journal of Surgery in June 2015, A study shows that as the age of the patient increases the failure and difficulty of transplantation increases. Also, it shows that patients who had heart surgery are 11 times at risk of death if they undergo transplantation.
The Insulin Pump
This is the third method to talk about, so what is it?
The insulin pump is a small automatic device that aims to replace multiple insulin injections that the patient suffers from especially the infants and the elderly.
How does it work?
The doctor places it under your skin in specific areas such as the abdomen. The pump infuses insulin in a continuous automatic manner. It pumps a very small amount of short-acting insulin continuously and a specified adjusted dose before meals. Its design tries to mimic the human pancreas.
Which patients can use it?
This method shows the effectiveness if you are a type 1 patient or type 2 patient whose pancreas is not functioning well or not functioning at all.
The Pros of Insulin Pump
The advantages of this method include:
- An insulin pump is easier to place.
- It considered less expensive than previous methods.
- Experts categorize it safer because it requires low or no amounts of immunity depressing drugs.
This method has a lower stimulation of immunity. The stimulation of immunity can cause serious reactions such as the rejection of the body to transplantations.
The Cons of Insulin Pump
The disadvantages include:
- Skin sensitivity to the device.
- It is less sensitive to the changes in the blood sugar levels than the artificial pancreas.
- The worry about delivering inappropriate doses to the patients.
A study in the Canadian Journal of Diabetes in June 2019 shows that there is no significant difference between patients who have the pump and those who have not the pump during 40 minutes of intensive exercise.
This method is already in use but requires attention to monitoring the patient’s health state, development of any complication and the impact on the quality of life.
Eventually, if you are diabetic and you are panicking from this disease or in the last stages, you can undergo any of the transplantations mentioned above. If you do afford an insulin pump, it is preferable to try this method. Because it will drop a great headache from your shoulders. For me, it is preferable not to use any of the transplantation methods due to their percentage of rejection and their side effects. In all cases, cheer up and always know that you are strong enough to pass this phase.
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