Living With Diabetes Is Getting Easier--And a Cure Could Be on the Way
The insulin side of the equation is improving as well. Most diabetics use two kinds: long-acting insulin to give a baseline blood level, and a short-acting form to give a boost at mealtimes. But long-acting insulin tends to peak after a few hours, requiring patients to eat in order to keep blood sugar from plummeting. Pager-shaped insulin pumps that infuse a steady trickle through a tube inserted into the skin make it easier to maintain a steady state. Lynn Statham, a 38-year-old California flight attendant, says that her pump helps her cope with flight delays and other schedule changes. "I tell it what dose to give me based on my activity and what I eat," she says. "That way I'm not bottoming out on the plane."
A new form of long-acting insulin set to be introduced in the fall by Aventis Pharmaceuticals in Parsippany, N.J., should also flatten the peaks, maintaining a steady level for 24 hours. And companies are testing inhaled forms of insulin that could one day eliminate injections completely while allowing patients to take insulin in frequent, small doses.
Impatient patients. Yet doctors say their phones are ringing off the hook from diabetics wanting islet-cell transplantation. "Patients have been waiting a long time for something like this," says Paul Robertson, scientific director and CEO of the Pacific Northwest Research Institute in Seattle.
Many hurdles remain. Like other transplant recipients, participants in the Alberta study have to take drugs that suppress their immune system so it won't reject the foreign cells. And donor islet cells are scarce. Each patient received cells from at least two pancreases--and just 3,000 are donated each year in the United States. "We simply need more islets," says Susan Bonner-Weir, a researcher at the Joslin Diabetes Center in Boston, who is trying to grow islet cells in the lab.
Pokerznik is thrilled with her new freedom but acknowledges that the therapy is still experimental. "For all I know, it will stop working tomorrow," she says. "Really, this is just the beginning."
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[Graphic labels:]
Pancreas; Islet; Liver; Pancreatic duct
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