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Transplanting Islets for Diabetes

FEATUREIslet Transplantation   ©1982 AMERICAN DIABETES ASSOCIATION How to overcome the remaining hurdles in cell survival, supply, and immune rejectionBY A.M. JAMES SHAPIRODiabetes prevalence has increased from a world estimate of 30 million in 1985 to 180 million currently, and is predicted to rise to 366 million by the year 2025. In developing countries such as China, the number of diagnosed cases is increasing at a frightening

Written byA. M. James Shapiro
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How to overcome the remaining hurdles in cell survival, supply, and immune rejection

Diabetes prevalence has increased from a world estimate of 30 million in 1985 to 180 million currently, and is predicted to rise to 366 million by the year 2025. In developing countries such as China, the number of diagnosed cases is increasing at a frightening rate of 3,000 per day. Upwards of one in 400 children becomes reliant on injected insulin due to type 1 diabetes (T1DM), and even this rate is on the rise. For these individuals, injected insulin is life-sustaining and prevents acute demise from ketoacidosis. Nevertheless, it fails to prevent inexorable secondary microvascular complications: Blindness, renal failure, stroke, neuropathy, amputation, myocardial ischemia, and infarction may occur and contribute to shortened lifespan. Clearly, injected insulin falls far short of the mark.

Alternative strategies to restore endogenous insulin include glucose-responsive closed-loop insulin pumps, whole-pancreas transplantation, and ...

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