Type-1 Diabetes Islet Cell Transplant:

A Repair of the Body and Mind

In seventh grade I started experiencing strange symptoms. At first they were not noticeable to me, but to my parents they were. They thought I was not taking care of myself or had an eating disorder of some sort. I had lost so much weight and I started to notice myself becoming extremely thin, I was so thirsty all the time and had to go to the bathroom an unusual number of times throughout the day. My parents thought it was best to get this checked out to make sure there was nothing serious before they left to go on vacation. We went to my pediatrician and as soon as they got results from a urine sample they sent us right to the emergency room. I was more confused than anything else because I really had no idea what was going on, I just listened to the people around me. When I got to the emergency room my blood sugar was tested and was an appalling 665, when the normal range is between 80 to 120. This meant there was too much sugar in my blood and if I had not gone to get checked out, I could have ended up in a coma. This was scary to hear and quite a shock to everyone in my family. The next few days were spent learning about the basics of managing diabetes and everything we needed to do in order to stay on top of it. My parents and I learned how to test my blood sugar, take insulin and measure the amount of carbs in the food I was eating, all of the daily routines that come along with having diabetes. But what they did not teach me, or even tell me, was that this would be a lot to handle emotionally. Being a young twelve-year-old girl I was not really emotionally affected at the time, in fact I did not really mind the attention or gifts I received from family and friends. It was not until a few years later in high school when it really hit me that this is not something that is going away and that is what began to frustrate me. While reading Repair by Elizabeth Spelman it occurred to me, that finding a cure for diabetes would not only be a form of physical repair, but emotional as well. Spelman begins her book by talking a lot about physical repair. For example, she used Willie and the other characters to sort of outline the different ways that objects can be repaired physically. As the book goes on, Spelman goes deeper into gender repair, care ethics, and emotional repair. Relating Type One Diabetes back to Repair was a difficult task because it was hard to pinpoint where exactly the physical and emotional aspects come into play.

For someone who is not diabetic, or does not know one with the disease, it can be very confusing to them. Type one diabetes is also known as juvenile diabetes or insulin-dependent diabetes. It is an autoimmune disease in which a person’s pancreas stops producing insulin, a hormone that enables people to get energy from food. When a person’s body stops producing insulin, his or her blood sugar starts increasing. Type one diabetes occurs when the body’s immune system attacks and ruins the insulin producing cells in the pancreas called beta cells. Type one diabetics have to rely on insulin to survive. Since their pancreas does not release insulin, diabetics must give themselves insulin. They do this by either injecting themselves with insulin or relying on a small device called a pump that attaches to their body and releases insulin into the bloodstream with the click of a button. Diabetics test their blood sugar before they eat, when they wake up in the morning, and before they go to bed at night. They always need to be on top of their sugar to make sure everything is steady with their body and their sugars stay in the normal range. When blood sugars are too high, which is also known as hyperglycemia, the diabetic must correct his or her blood sugar and give themselves more insulin. One cause of high blood sugars is not giving enough or any insulin. Other things such as stress and illnesses can cause blood sugars to rise. When blood sugars are too low, also known as hypoglycemia, the person must take a “fast acting” sugar such as a juice-box or sugary candies, for example. (My Own Experience)

Type one diabetes statistics in the United States. (diabetes.org)

About 10 percent of the American population is type one Diabetic. As of 2012 approximately 1.25 million American children and adults had type one diabetes. About 1.4 million Americans are diagnosed with diabetes each year. In 2010, type one diabetes was the 7th leading cause of death in the United States. Imagine a world where these statistics were decreased by thousands…even millions? Today, in our modern world, this is quite possible. There are many potential cures for type one diabetes being researched and perfected right now; specifically, a cure that researchers, scientists, and doctors have been working on called the Islet Cell Transplant, or The Edmonton Protocol. Over the past four decades, this procedure has been studied, tested, and evolved over the past years. During the “pancreatic islet transplantation, cells are taken from a donor pancreas and transferred into another person. Once implanted, the new islets begin to make and release insulin,” (Islet Transplantation). This is amazing because once the new islet cells get comfortable in the new body, they can produce insulin like normal. It is a short procedure and for the most part is easy to complete:

In this procedure, researchers use specialized enzymes to remove islets from the pancreas of a deceased donor. For an average-size person (70 kg), a typical transplant requires about 1 million islets, equal to two donor organs. Because the islets are extremely fragile, transplantation occurs immediately after they are removed. The transplant itself is easy and takes less than an hour to complete. The surgeon uses ultrasound to guide placement of a small plastic tube (catheter) through the upper abdomen and into the liver. The islets are then injected through the catheter into the liver. (Islet Transplantation)

For the most part this operation can be done quickly and without any complications. Following the procedure there are precautions that need to be taken. It takes some time for the new cells to attach to the blood vessels and start to release insulin. The patient’s blood sugar must be monitored following the operation and for the next following days insulin may need to be injected to control the blood sugar. Anti-rejection drugs are also needed to keep the cells functioning. Researchers are even looking into animal islets or transplanting the cells from animals, such as pigs, into the human patient. This would allow for more diabetics able to receive the transplant since there are limited amounts of human islet cells available.

The Edmonton Protocol began in the 1970’s when first the islet transplant was experimented on mice and, shockingly worked. Following the excitement of the successful work on the mice, the success then slowed down. Many of the human trials did not work and the patients only stayed “diabetes free” for only a few months until the islet cells started to fail (Islet Transplantation). Now, over forty years later our society has come such a long way. Now we have several cures of type one diabetes being researched. This is such a great accomplishment, and leaves diabetics all over the world with hope, myself included. Being a type one diabetic is something that completely flipped my entire world upside down at first and now it is something that has become part of my everyday life. If there was a cure for type one diabetes, the first thing that I would feel would be relief and just a huge weight had been taken off of my shoulders. It would be an enormous worry removed from my daily life.

Surely, people with diabetes have a lot of physical struggles they need to deal with, but they also have a lot of mental struggles as well. Not only do they have to prick their fingers or take insulin, either themselves or with their pump, but they also have a lot of added stress put on them because of this and the disease can be depressing at times. It is frustrating for the diabetics to know that this will not go away and it will be there with them for the rest of their lives. Some mornings this is not something that you want to wake up and deal with so it really can take a toll on people. The idea of a cure for diabetes gives many people hope. A cure would affect so many people around the world and make their everyday lives simpler. The cure itself is physical repair. Obviously, surgery entails physical scars and things you can see with the human eye, but what you cannot see is how this affects the recipient mentally, emotionally. The person’s life will change completely after receiving something like this. The daily life of the patient will be so much easier, with less responsibility and having to think about everything that they eat or drink. That is where Spelman’s emotional repair comes in.

A specific, successful trial of the islet transplant was performed on Wendy Peacock, a 43- year-old woman from San Antonio. She underwent the transplant at Jackson Memorial in mid-August of 2015. In early September, shortly after receiving the cells, researchers announced that the cells were working like a natural pancreas. They sensed her blood sugar levels and then released insulin based on what the sugar level was. There have also been islet transplants where the islet cells are transplanted into the liver. It is amazing that something like this has become successful in our world today. Although right now the transplants are only being used on patients with diabetes that is hard to manage and therefore more dangerous, eventually this could mean a cure for all diabetics around the world. (Harrar)

Wendy Peacock with her team of doctors following her Islet Cell Transplant. (diabeteslifestyle.com)

This specific repair is done physically on the body, and all of them are of course, but they are not only repairing that. With a disease like diabetes being cured, so much more than the body is being repaired. There would be so much less stress, so much freedom, less responsibility, more happiness. I think that the curing of type one diabetes relates to Spelman’s book Repair as a whole. Spelman starts off in Repair by explaining the repair of certain objects, such as cars. Curing diabetes would be most like Willie’s form of repair: making the body as good as new, or in this case, making the pancreas and insulin cells as good as new, but this is only looking at things on a physical level. There is so much more being repaired with finding such a cure. As Spelman gets deeper into her book, she begins talking about care ethics and emotional repair. The emotional repair aspect of curing diseases is something that I think is often overlooked, not only with diabetes, but with many other health problems that people struggle with. With such a disease that needs to be taken care of and managed all the time, the mental struggle that the patients go through is underrated, therefore the emotional repair on the patients would be an even greater addition to the physical repair.

The fact that there is potential for type one diabetes to be cured is incredible. Right now about 30 million people in the United States are diabetics and go through the everyday struggle. Just imagine if that number could be cut down by thousands or even millions. Science and research have developed beyond belief over the years and it truly is remarkable what has been achieved thus far and what can be achieved in the future. Curing type one diabetes is an amazing accomplishment and is capable of changing so many people’s lives. Knowing that one day it is highly probable that I will be able to say that I am no longer a type one diabetic is a great feeling.

Acknowledgments

I would like to thank my group members — Hannah, Brittany, and Tyler. They truly helped to form the beginning of my essay and build it to become its final draft. They provided editing, friendly advice, and constructive criticism to improve my writing. I would also like to thank my sister for reading over my essay and giving me meaningful advice and my mom for correcting simple mistakes I had made and revising my later drafts to pave the way for it to become my final draft. Another huge thank you to Professor Harris and Megan for advising me during my conferences and offering even more assistance towards making my piece the best it could be. I would not be improving in writing if it was not for any of these important people!

Works Cited

“Islet Transplantation.” American Diabetes Association. N.p., n.d. Web. 09 Nov. 2016.

Harrar, Sari. “No More Insulin Shots, Thanks to a New Type of Islet-Cell Transplant.” EndocrineWeb. N.p., n.d. Web. 09 Nov. 2016.

Spelman, Elizabeth V. Repair: The Impulse to Restore in a Fragile World. Boston: Beacon, 2002. Print.

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