Type 1 diabetes happens when insulin-producing cells in the pancreas are destroyed by the immune system. The regions of the pancreas which contain insulin-producing cells are called islets.
In islet transplants, doctors can transplant islet cells from donors into people with Type 1 diabetes to replace some of the cells that have been destroyed.
Islet transplants can be life-changing, and even life-saving. They're available through the NHS for people with Type 1 diabetes who have lost their hypo awareness and have severe hypos. And that's in large part thanks to the research we've funded in this area.
How do islet transplants work?
Islet transplants involve extracting islet cells from a donated pancreas and implanting them into the liver of someone with Type 1 diabetes. It's a minor procedure that can be done under local anesthetic. Usually people will need two separate transplants to see the benefit.
Islets transplants help people with Type 1 diabetes to produce their own insulin again. This can lead to massive benefits, like fewer severe hypos, regaining hypo awareness, improved blood glucose control and better quality of life.
Some people are able to stop taking insulin for a period after a transplant (usually between one to five years), but eventually will need to resume insulin therapy.
We made it happen
Our scientists, led by Dr Roger James and Dr Stephen Lake, developed a way to collect islets for transplant in 1989, allowing the first ever transplant to take place in Canada. The method they pioneered is still regarded as the gold standard today.
Soon after we launched the UK Islet Transplant Consortium, which brought together leading researchers around the country to ensure islet transplants would become available in the UK. Off the back of this, our supporters raised £650,000 which paid for the UK’s first 15 islet transplants from 2005.
By 2008, islet transplants were made available on the NHS for some people with Type 1 diabetes.
"Before my transplant, I was also getting no signs of hypos. This was another reason my doctors decided to try the transplant. Since I have had the transplants, I'm starting to get some signs of hypos back. I'm more prepared when they happen now, it is improving so we're getting there slowly."
Bruce had an islet transplant in 2014. Read Bruce's story to find out more.
But there's more to do
Islet transplants aren't perfect yet so we're continuing to support research right now to make them even better.
A new approach to islet transplant
Professor James Shaw at Newcastle University
Transplanted islet cells stop working over time and follow-up transplants become necessary. Professor Shaw is looking at a new approach, which has the potential to prolong the life of transplanted islets.
Since islet cells need a constant supply of blood and oxygen, Professor Shaw is investigating a technique where islets are transplanted together with cells called endothelial progenitor cells. He is hoping these cells will encourage new blood vessels to grow around the newly transplanted islets, providing them with oxygen and improving their survival. This project is still at an early stage, but if the approach is tested in humans and proves successful, it may replace the current islet transplant technique.
Maintaining islet cell function
Professor Shanta Persaud at King's College London
Professor Persaud will investigate the role of a protein found on insulin-producing cells. She's already shown that when this particular protein is activated insulin production is higher, and that mice who don't have this protein have smaller islets.
The researchers are now looking at whether the protein can be used to improve the survival of islets after transplantation in Type 1 diabetes, to improve the effectiveness of this treatment.