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Hope for 250,000 sufferers as British diabetic is 'cured'

Health Editor,Jeremy Laurance
Wednesday 09 March 2005 01:00 GMT
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Doctors claimed a breakthrough in the treatment of diabetes after announcing the first British patient to be "cured" by transplant.

Doctors claimed a breakthrough in the treatment of diabetes after announcing the first British patient to be "cured" by transplant.

Richard Lane, 61, was having five insulin injections a day to control the diabetes from which he has suffered for almost three decades. But after three transplants of islet cells, the insulin-producing cells in the pancreas, from three separate donors he no longer needs injections to control the condition and is leading a normal life.

"I am not just happy I am euphoric," Mr Lane said. "After 30 years of having to count the carbohydrates at every meal and a constant fear of blackouts I don't have to worry. I have got all my energy and enthusiasm back. I am so lucky."

Doctors at King's College Hospital in London, who performed the transplant, said it heralded a new era for the 250,000 patients with type 1 diabetes like Mr Lane's, who are dependent on daily insulin injections.

Professor Stephanie Amiel, consultant in diabetes who led the team, said: "This breakthrough is hugely exciting. The implications for the future are enormous. Eventually this could mean the end of insulin dependence for all type 1 diabetes sufferers."

Mr Lane, of Bromley, Kent, had to retire from his job as a partner in an accountancy firm and give up some of his charitable work because of ill health. He had a serious car accident in 1997 after suffering a blackout when his blood sugar fell too low and required major surgery on his spine.

"Last July my doctors said I had to do something drastic. I was losing control of my diabetes and they said I ought to consider this operation. It has been fantastic."

The transplant, conducted under local anaesthetic, involved infusing islet cells extracted from cadavers through a cannula into the portal vein that supplies the liver. The cells become lodged in the liver where they function to produce insulin similar to a normal pancreas. Mr Lane said: "I still have to take a tiny bit of insulin at night - three units compared to 80 at my peak - but that is just to protect the islet cells, not to control my blood sugar. The doctors hope to stop it in a week or so."

Mr Lane, who is married with two children, said his family had stopped worrying about him. "My wife used to dread me going out of the front door in case I blacked out," he said.

The King's College team said it had transplanted three diabetes patients with islet cells but only Mr Lane had achieved complete success.

The others still required small doses of insulin to control their diabetes. A Canadian team was the first to achieve complete insulin independence following a transplant.

Inadequate control of blood sugar levels in diabetes carries the threat of long-term complications including blindness, kidney failure, poor circulation leading to amputation and heart disease. The main drawback of islet cell transplants is the shortage of donors and patients have to take anti-rejection drugs for the rest of their lives, which lower immunity and can increase the risk of cancer.

The treatment is currently being offered only to those who have major problems with conventional insulin therapy or who are suffering dangerous hypoglycaemic (low blood sugar) attacks.

Islet cell transplants were pioneered by a British surgeon, James Shapiro, at the University of Alberta in Canada. In 2000, he reported that seven patients had been insulin independent for 11 months. The King's College team has been working on refining the technique for growing, harvesting and transplanting the cells and is the only centre in the UK offering it as a treatment.

An estimated 15 per cent of patients with type 1 diabetes who have uncontrolled hypoglycaemia could be eligible for the procedure at its present stage of development, specialists said.

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