Manchester Royal Infirmary provides pioneering diabetes treatment
A clinical team based at Manchester Royal Infirmary (MRI) has recently treated its first patient with a pancreatic islet cell transplant – a first for the North West of England.
This potentially life-saving therapy is given to patients with type I diabetes, who rely entirely on multiple daily insulin injections and needle-stick blood glucose monitoring. Even though they eat healthily and take their insulin injections properly, some patients find it impossible to stop their blood sugar levels from going dangerously low, called a “hypo” or hypoglycaemia.
These patients live in constant fear of hypos, which can occur without any warning, and cause confusion, abnormal behaviour, accidents, unconsciousness or even death. This carries a devastating impact on someone's life. Patients who suffer from repeated bouts of severe hypoglycaemia are often unable to work, drive, take holidays away from home or go anywhere alone in case they collapse with a hypo. This situation can lead to severe anxiety, depression and a very poor quality of life.
This new treatment involves taking insulin-producing "islet cells" from organ donor tissue, which may come from anywhere in the country, and injecting these cells into a vein behind the liver. If successful, the islet cells make insulin, and stabilise the blood sugar levels in the patient.
Manchester's first patient, Mr Leslie Jones, said: "This treatment has been fantastic! Before my transplant, I was always eating to avoid "hypos", and now, it's like the clock has been turned back to when my diabetes was easy, though, at the moment, I still have to take a small amount of insulin. This will bring new hope for patients with diabetes."
MRI, part of the Central Manchester University Hospitals NHS Foundation Trust, is one of six UK centres that are able to offer this new treatment. Patients from the North West, Wales, South Yorkshire and the Midlands come to Manchester to be assessed for their suitability for the treatment. Manchester was chosen as a regional site because of its expertise in transplantation and excellence in treating diabetes. More than 4,000 transplants, mainly of kidneys, have been carried out at the MRI since 1968.
The islet cell transplant programme is run jointly by Dr Martin Rutter, Senior Lecturer at The University of Manchester and Consultant at the Manchester Diabetes Centre, MRI, and Mr Neil Parrott, Consultant Transplant Surgeon, Manchester Royal Infirmary.
"Team work has been the key to our success", explained Dr Rutter. "We could not have done this without the fantastic support of the transplant team, the radiologists, specialist nurses and the scientists supporting the programme. This is an excellent new therapy that appears to give long-lasting benefit for most patients. Five years after having an islet transplant, approximately four out of every five patients treated continue to have better control of their diabetes, fewer severe hypos, and better quality of life, and most patients are able to stop their insulin injections for one to two years.”
Dr Rutter’s team is involved in several research studies with colleagues in Newcastle, Oxford, London and Bristol to look at the clinical and psychological benefits of islet cell transplantation.
He said: "We are constantly trying to improve our treatment, and we are delighted that most patients who received an islet cell transplant take part in research programmes designed to refine our techniques and identify those patients who can be helped the most. Many patients with difficult diabetes live in constant fear of hypos, and this treatment seems to be very helpful for these people in particular. We do hope that in the future a wider range of patients will be suitable for this treatment. However, the benefits must always be balanced against the risks, which include possible side effects of long-term drug therapy given to prevent rejection.
“Around 20 people have already had an islet cell transplants in the UK, and we expect around 60 people to receive islet cell transplants in the next few years,” added Dr Rutter. "Of course, the major issue is availability of donated pancreases and we encourage everyone to offer organs for donation where appropriate. The UK islet cell transplantation service is the only government-funded islet cell transplant program in the world. We hope our research into the psychological as well as the clinical outcomes will help to secure long term funding for it.”
Diabetes UK and the Department of Health, who set up the programme, have provided funding for the research. The work also brings new patient-centred research opportunities to the wider diabetes research team at MRI and the University, which receives multi-million pound funding from the United States National Institutes of Health and Juvenile Diabetes Research Foundation. Locally, the research has been supported by the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (MBRC).
Professor Neil Hanley, who leads Endocrinology and Diabetes research at the NIHR MBRC, said: “This is a fantastic programme which is making a huge difference to people with one of the most difficult to manage forms of type 1 diabetes. It is a great example of where investing in research led by cutting-edge clinicians and scientists can make a massive impact on a person’s life. It is wonderful that Manchester is a part of this.”
Notes to editors:
Central Manchester University Hospitals NHS Foundation Trust is a leading provider of specialist healthcare services in Manchester, treating more than a million patients every year. Its five specialist hospitals (Manchester Royal Infirmary, Saint Mary’s Hospital, Royal Manchester Children’s Hospital, Manchester Royal Eye Hospital and the University Dental Hospital of Manchester) are home to hundreds of world class clinicians and academic staff committed to finding patients the best care and treatments. www.cmft.nhs.uk
The NIHR Manchester Biomedical Research Centre was created by the National Institute for Health Research in 2008 to effectively move scientific breakthroughs from the laboratory, through clinical trials and into practice within hospitals to improve patient care. As a partnership between Central Manchester University Hospitals NHS Foundation Trust and The University of Manchester, the Biomedical Research Centre is designated as a specialist centre of excellence in genetics and developmental medicine. www.manchesterbrc.org
The University of Manchester, a member of the Russell Group, is the largest single-site university in the UK. It has 22 academic schools and hundreds of specialist research groups undertaking pioneering multi-disciplinary teaching and research of worldwide significance. According to the results of the 2008 Research Assessment Exercise, The University of Manchester is now one of the country’s major research universities, rated third in the UK in terms of ‘research power’. The University had an annual income of £755 million in 2008/09. www.manchester.ac.uk
Diabetes UK is the leading charity for over 3.5 million people in the UK with diabetes, funding research, campaigning and helping people living with the condition. Our mission is to improve the lives of people with diabetes and work towards a future without diabetes. All of this and more is only made possible through donations and by people supporting Diabetes UK. For more information visit www.diabetes.org.uk
Juvenile Diabetes Research Foundation exists to find the cure for type 1 diabetes and its complications, and is the world’s leading charitable funder of type 1 diabetes research. At a global level JDRF volunteers and staff have been responsible for raising over £850 million to support type 1 diabetes research since the charity’s inception. www.jdrf.org.uk
- Type 1 diabetes is a chronic, life-threatening condition that has a life-long impact on those diagnosed with it and their families. JDRF exists to find the cure for type 1 diabetes.
- It is an autoimmune condition that is not caused by lifestyle and cannot currently be prevented.
- People with type 1 diabetes rely on multiple insulin injections or pump infusions every day just to stay alive, until we find the cure.
- It normally strikes children and stays with them for the rest of their lives.
- Type 1 diabetes affects about 350,000 people in the UK, 25,000 of them children.
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