Position statements
Stem cell research and diabetes
Since its inception in 1934, Diabetes UK has supported a wide range of research aimed at finding a cure and improving the care and prevention of diabetes and its complications.
Stem cell research is a relatively new area of investigation, believed by many in the scientific and medical communities to have important new potential for the treatment of many diseases and conditions particularly those like diabetes, which are characterised by severe damage to certain cells and tissues. We cannot know what benefits any particular avenue of research may yield in the long term. The potential of human stem cell research is that it could lead to the identification of the pathway that results in the production of functioning, insulin-producing islet cells. This could provide potentially limitless supplies of islet cells to become available for transplantation (see below for more information).
It could also become a source of kidney, nerve and heart muscle cells for people whose organs have been damaged by the complications of diabetes. There are important ethical issues concerning stem cell research, in particular about the use of stem cells derived from early human embryos (pre-14 days old). Some people oppose the research on ethical grounds.
Following wide-ranging consultation with members about the ethical issues, Diabetes UK’s Board of Trustees, has agreed to support stem cell research both publicly, and financially through our research grant programme. In making their decision the Trustees paid respectful attention to all the arguments and took into consideration the views of people living with diabetes. Our consultation activities indicated that almost all people living with diabetes approved the continuation of carefully regulated and monitored stem cell research and an overwhelming majority favoured the use of embryonic stem cells. The Trustees gave consideration to concerns about cell nuclear replacement and the question of whether the research should be confined to embryos left over from in-vitro fertilisation treatment (IVF), and not involve the creation of new embryos.
The Trustees, however, were in favour, in principle, of cell nuclear replacement research, when the knowledge base has advanced to a stage when this would be worth considering. Their reasoning was that cell nuclear replacement could potentially lead to the generation of islet cells that are genetically compatible with the intended recipient. Such individually compatible islet cells might reduce the need for lifelong immune suppressant drugs, which are currently required for islet cell transplantation. This could greatly widen the applicability of islet cell transplantation. We do not know, however, whether the auto-immune reaction, which initially destroyed the islet cells and caused diabetes, would attack any newly implanted islet cells. It was felt that more needs to be known in this area before cell nuclear replacement finds significant application in diabetes research to potential treatments for human diabetes.
The current legal position in the UK allows both stem cell research and cell nuclear replacement research, following amendments to the Human Fertilisation and Embryology Act (1990) in 2000, based on the recommendations of the Donaldson Report. This means that research involving early embryos (pre-14 days) is no longer limited to the area of reproduction but can be applied to any disease or condition. Any such investigations, however, are carefully regulated. The Act put in place safeguards intended to prevent the abuse of such research, eg for reproductive cloning. In all cases, researchers must satisfy the Human Fertilisation and Embryology Authority (HFEA) that no feasible alternatives exist to the use of embryos in their research and they must obtain a specific licence from the HFEA for each project involving the use of cells from pre-14 day old embryos. All research also needs the approval of a Research Ethics Committee (LREC or MREC). The Trustees were satisfied that this legal framework will provide adequate safeguards and agreed that Diabetes UK should take the necessary steps to ensure we comply with such requirements.
All applications for Diabetes UK grants are subject to rigorous scrutiny in terms of the quality and relevance of the research to people with diabetes and stem cell research will have to compete along with the other applications for research funding. The advice of a medical ethicist is available for the consideration of grant applications.
Diabetes UK will continue to monitor the development of stem cell research, and its continued research will be subject to a formal annual review in respect of progress in this field and its changing relevance to people with diabetes.
For further information about this position statement,
please contact the Policy team, by emailing: policy@diabetes.org.uk
For further information on islet cell transplantation or
stem cell research please contact the Islet Project Coordinator by emailing: islets@diabetes.org.uk
February 2002 (Reviewed April 2006)