Case of 'Diabetes Cure' with Stem Cell Therapy Emerged [MilDang365]

 

Diabetes is a disease closely related to pancreatic function. As the beta cells that produce insulin are destroyed or gradually lose their function, insulin therapy becomes necessary. Recently, research has been published showing that diabetes can be completely cured by injecting cell therapy agents that replace beta cell function in the patient's body.

Today's Diabetes Letter: a two-line summary
The world's first case of diabetes being cured with stem cell therapy has been revealed.
2. To commercialize, it is necessary to increase the research population and conduct long-term follow-up observations.

Stem cell transplantation improves blood sugar levels
The participant in this clinical trial conducted at Changzheng Hospital in Shanghai, China, is a 59-year-old Chinese man who has been living with diabetes for 25 years. He received a kidney transplant in June 2017 due to end-stage diabetic nephropathy. Since then, his blood sugar control has been poor, requiring daily diabetes medication and multiple insulin injections, ultimately leading to the decision to undergo stem cell transplantation therapy.

The research team followed up with the patients for 116 weeks after stem cell transplantation. The participants' blood glucose levels were measured in real-time using a continuous glucose monitor. Two weeks after transplantation, the blood glucose fluctuation range decreased from 5.50 mmol/L to 3.60 mmol/L, and the TIR increased from 56.7% to 77.8%. TIR is a measure that expresses the percentage of time during the day when blood glucose levels are within the target range, and maintaining it above 70% is considered ideal.

Between 4 and 12 weeks, the blood glucose fluctuation decreased to 2.6 mmol/L, and the TIR increased to a maximum of 90%. After 32 weeks, the TIR reached 99%, and the blood glucose fluctuation decreased to 1.6 mmol/L. The figures then remained consistently maintained.

The research team announced that they gradually reduced the patient's insulin dosage and completely discontinued it after one year. The HbA1c level, which was 6.6% at week 85, decreased to 4.6% at week 113. Compared to before stem cell transplantation, the average fasting C-peptide level increased threefold. C-peptide levels are an indicator of how much insulin the pancreas is secreting. Severe hyperglycemia or hypoglycemia that exceeded the target blood sugar control range no longer occurred.

Discontinued all insulin and oral medication, diagnosed as 'cured'
The most notable point in this study is that the participants' insulin requirements gradually decreased, leading to the cessation of insulin injections at the 11th week post-transplantation. Oral hypoglycemic agents (▲glimepiride ▲metformin) were gradually reduced starting from the 44th week, with glimepiride discontinued by the 48th week and metformin by the 56th week. The participants remained in a state requiring no insulin even 2 years and 9 months after the publication of the paper, receiving a diagnosis of complete remission.

Insulin substitution has been confirmed, but there are also limitations.
Experts consider this clinical study to be a very meaningful result. Professor Cha Byeong-hyun from the Department of System Immunology at Kangwon National University College of Biomedical Sciences said, "Insulin is a drug that has been recognized for its safety and efficacy over a long period, but it requires frequent administration due to its duration of action, which can be inconvenient." He added, "Therefore, this clinical trial is significant because it reduces the inconvenience of insulin administration."

Meanwhile, several limitations must be overcome for stem cell therapy to be commercialized. The clinical study involved only one participant, and safety and side effect issues have not been resolved. Participants experienced temporary abdominal bloating and loss of appetite for 4 to 8 weeks after stem cell transplantation. Professor Cha Byung-hyun stated, "Transplanting human-derived stem cells carries the risk of them transforming into cancer cells, so this is also a problem that must be addressed through long-term follow-up."

Based on clinical results, appropriate consideration of ▲treatment development costs, ▲product manufacturing costs, and ▲the practicality of the treatment as an actual therapy is necessary to reach the commercialization stage. Professor Cha stated, "Considering that the previous research took about 12 years from basic research to clinical application, it is expected that stem cell therapy will take at least 10 years to become commercially available."