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‘A godsend’: Study on 20 years of the Edmonton Protocol highlights its effectiveness in treating diabetes

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After being diagnosed with type 1 diabetes in 2003, Nina Green said her life became a revolving door of hospital visits.

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Green lives in Fort McMurray, about 430 kilometers northeast of Edmonton, and suffers from a variety of particularly difficult to control conditions known as “brittle diabetes,” as patients struggle to keep their blood sugar levels in check. She was previously using an insulin pump, and had to switch to insulin injections after complications from the device led to stomach infections.

“But every time I take insulin, the sugar goes down, so I’m going to have to take sugar, and then the sugar goes up, so I’m going to have to take more insulin,” Green, 54, told Postmedia in a phone interview. . “I’ve never had diabetes.”

The condition made her an ideal candidate for the treatment offered at the University of Alberta Hospital, which involves transplanting insulin-producing islet cells into the patient’s liver by injection.

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After receiving the “call” late one night in January 2017, Green recalls, she was in Edmonton by 3 a.m. the next day, anticipating an action that effectively changed her life. She added that she became “insulin-free” about a year after receiving the transplant, and has been since.

Dr. James Shapiro, Professor of Surgery at the University of Alberta’s College of Medicine and Dentistry, leads the team behind the procedure known as the Edmonton Protocol.

He is also one of the authors of a research paper published in May in The Lancet that reported 20 years of data from 255 patients who received treatment between March 1999 and October 2019. According to the findings, nearly 80 percent of transplant patients achieved autonomy. insulin for some time.

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“We’ve learned this is very effective, and now we’re focused on how to make it more accessible to all patients who could benefit,” Shapiro said in a phone interview.

Shapiro, who is also Canada Research Chair in Regenerative Medicine and Transplant Surgery, explained that while growing up in the pancreas, it is transplanted into the liver because it has a good blood supply, while interfering with the pancreas can cause complications.

So far, Shapiro said, the procedure has only been used in people with fragile diabetes because of the “fragile control” patients have over their blood sugar levels.

“When blood sugar drops below a certain level, the brain stops immediately,” Shapiro said. “Neural cells don’t work anymore, and people can die from it.”

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Moreover, the immunosuppressive drugs needed to prevent the body from rejecting the transplant have in some cases led to life-threatening precancerous diseases and infections. hint towards the latter.

This does not mean that other forms of diabetes are not in his sight. Shapiro was careful to note that although the Edmonton Protocol is not a cure for diabetes, given the need for anti-rejection drugs and the supply problem due to dependence on donors, the research is heading in the right direction.

His lab these days is looking at creating islet cells from stem cells using blood from patients with type 1 and type 2 diabetes.

“It can be done fairly routinely now with a lot of work and skill, because of enabling the scientific advances that have occurred in the past 20 years,” he said.

But for now, Green is grateful to the Edmonton Protocol and the team behind it for the stability they gave her.

Green said that out of the days when her husband had to regularly take her to the hospital, she has since enjoyed “ideal” blood sugar levels, adding that she still monitors them with regular blood tests.

“It was a godsend,” she added. “They definitely saved my life.”

hissawi@postmedia.com

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2022-05-23 23:51:56

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