Generally, type 1 diabetes is managed with insulin therapy, diet, and exercise. However, in some cases, transplant of the pancreas or islet cells might be an option.

Pancreas Transplant

A pancreas transplant is done only in a few medical centers in the US. This procedure is an acceptable alternative if you:

  • Have developed severe renal disease especially if you may need a kidney transplant
  • Have tried insulin treatment, but it has failed to prevent acute complications, like ketoacidosis
  • Have severe emotional problems due to insulin treatment
  • Have frequent, potentially life-threatening complications, like repeatedly getting pneumonia

Kidney damage is a common complication of type 1 diabetes. Many people with diabetes end up with kidney failure that requires regular dialysis. In most cases, a pancreas transplant is done along with a kidney transplant. There is good evidence that quality of life significantly improves if these two transplants are done together.

Some doctors, though, do transplant only the pancreas. This is done in cases where the patient does not have kidney failure. Compared to pancrease-kidney transplant, the benefits of just a pancreas transplant are not as clear.

If you receive one or more transplanted organs, you will need to take immunosuppressive drugs for the rest of your life. These drugs prevent the immune system from attacking your new organ. However, these drugs have many severe side effects, including high blood pressure, hearing loss, nausea, gastric ulcers, and bacterial and viral infections. Also, some of these drugs may increase your blood sugar level.

Islet Cell Transplant

There has been a great deal of research into islet cell transplant. Islets are a mass of cells located in the pancreas. Only 1%-2% of the pancreas is made of islet cells. About 75%-80% of these are beta cells, which are the cells that normally produce insulin. Alpha cells make glucagon, a hormone that raises blood sugar. Transplanting islets are technically easier to transplant than an entire pancreas.

Islet Cells

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Unfortunately, beta cells are very fragile. Many do not survive the transplant procedure. In addition, the immunosuppressive drugs seem to impair the insulin-producing ability of the new cells and cause many side effects. Researchers are investigating the best ways to transplant islet cells.