By:

Louis A. Cona, MD

Reviewed:

Robert J. Hancock

Can this revolutionary stem cell treatment cure Type 1 diabetes? Treatment aims to reduce insulin dependence. Learn more about the current research being conducted.

Stem cell therapy for diabetes, utilizing umbilical cord tissue-derived cells, offers a promising treatment by generating insulin-producing islet cells.

This innovative approach not only reduces insulin dependency but also provides long-term benefits from a single infusion, potentially transforming diabetes management and improving patients' quality of life.

Stem cells for Type 1 Diabetes

Stem cells for Type 1 diabetes is an exciting new treatment option that has been extensively studied recently. Type 1 diabetes, or juvenile diabetes, is an autoimmune disease that influences immune cells to destroy the insulin-producing beta cells in the pancreas. This leads to a lack of insulin, a hormone that regulates blood sugar levels, and requires patients to monitor their blood sugar and administer insulin injections constantly.

Mesenchymal stem cells (MSCs) have shown great promise as a potential treatment for Type 1 diabetes. MSCs are adult stem cells in various tissues, such as umbilical cord tissue, bone marrow, and fat.  Stem cell for diabetes can reduce inflammation, modulate the immune system and differentiate into different cell types.

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"The International Diabetes Federation predicts that by 2045, nearly 700 million adults will have diabetes. The cause of diabetes, specifically Type 1 diabetes (T1D), is not fully understood, but research suggests a combination of genetic, environmental, and viral factors may contribute to its development. Currently, the most widely used treatment for T1D is administering insulin externally, but it does not provide a cure for the disease." (1)

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Stem Cell Therapy for Diabetes Success Rate

The success rate of stem cell treatment for diabetes at DVC Stem roughly 80%. This is calculated by either a reduction in inflammatory markers, increased organ function or improved metrics in the patients quality of life PAR-Q questionnaire.

Stem cell therapy is also gaining traction in treating diabetes, especially type 2 diabetes, with a notable success rate in India. Key aspects include:

• Success Rate: In India, the success rate for treating diabetes mellitus with stem cell therapy is around 70-80%, as noted in this study.

• Therapy Process: The therapy introduces stem cells into diseased tissue to stimulate the body's self-healing. Stem cells can be sourced from bone marrow, the umbilical cord, or adults.

• Insulin-Producing Cells: Transplanting stem cells that differentiate into insulin-producing cells is a key strategy for managing type 2 diabetes.

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Despite its promise, stem cell therapy is an emerging field. More research is needed to fully understand its potential and limitations in diabetes treatment.

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Stem cell biology suggests promise as a way to treat diabetes

Stem cells are considered an up-and-coming new treatment option for Type 1 diabetes due to their ability to differentiate into multiple cell types and regenerative capabilities. Their versatile differentiation potential makes stem cells a promising treatment option for repopulating damaged tissues.

‍Mesenchymal stem cells (MSCs), in particular, have gained significant attention in treating Type 1 diabetes due to their ability to regulate fibrosis and tissue regeneration, modulate the immune system, and produce various molecules that aid in treating type 1 diabetes, such as cytokines and exosomes.

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Types of stem cells and their origin

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Immune system modulation plays a vital role

Also, MSCs have been shown to have immunomodulatory properties, which means that they can help suppress the immune response responsible for destroying the beta cells in the first place. This means that stem cell treatment may replace the lost beta cells and prevent further destruction of these cells.

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"Stem cells can promote the formation of new blood vessels by releasing specific proteins like the essential fibroblast growth factor and VEGF. They also play a vital role in regulating the immune system by moving to areas of inflammation and changing the characteristics of cells like dendritic cells, T cells, B cells, and natural killer cells. MSCs can decrease the production of pro-inflammatory proteins and avoid being killed by T cells, inhibit the maturation of dendritic cells, and reduce the growth of T lymphocytes by promoting the production of regulatory T cells through TGF-beta1, HGF, and nitric oxide. "

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Clinical trial results for Type 1 diabetes (T1D)

Several studies on animal models of Type 1 diabetes have shown promising results using MSCs as a treatment. Some studies report that the transplanted MSCs could differentiate into insulin-producing cells and improve blood sugar control. However, more research is needed before stem cells for Type 1 diabetes can be translated into a treatment for human patients.

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Mesenchymal stem cells (MSCs) have been proposed to have a role in Diabetes and other conditions through various mechanisms. These include homing to the site of injury and regulating the immune system. One review found that MSCs can effectively lower fasting blood sugar, C-peptide, and hemoglobin A1c levels and treat microvascular complications associated with T1D. (1) However, the exact cause of T1D is poorly understood, making it challenging to develop new treatments.

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Several mechanisms have been discovered to play a role in the management of T1D by MSCs

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Stem cell clinical trials for Type 1 diabetes

Research using stem cells for diabetes has been overwhelmingly positive, showing promising results for treating type 1 and 2 diabetes. The use of stem cells in treating diabetes has been shown to improve blood sugar control and potentially restore the function of insulin-producing beta cells in the pancreas. This is particularly important for patients with type 1 diabetes who depend on insulin injections for their entire lives.

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"According to a phase I/II randomized placebo-controlled clinical trial study conducted in June 2022, The use of MSCs in transplantation has been found to lead to improvements in HbA1c levels, a shift in the balance of cytokines in the blood from pro-inflammatory to anti-inflammatory, an increase in the number of regulatory T-cells in the peripheral blood, and an improvement in overall quality of life.  Patients experienced rapid and robust improvements after stem cell infusion." (3)

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Early transplantation of MSCs, in particular, was shown to significantly impact HbA1c and C-peptide levels, as well as a shift in pro-inflammatory cytokines to anti-inflammatory cytokines. Additionally, combining exercise with MSCs transplantation enhanced the benefits, improving glycemic and immunologic indices. (3)

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Why use mesenchymal stem cells?

Mesenchymal stem cells (MSCs) have a superior biosafety profile in the human body and negligible risk of tumorigenicity compared with induced pluripotent, hematopoietic stem cells or embryonic stem cells.  This makes them an attractive option for treating or reversing diabetes due to their ability to modulate the immune system and promote regeneration, lack of immune response due to the absence of major histocompatibility complex (MHC) class II, and their ability to target damaged pancreatic islets and nearby lymph nodes.

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Current stem cell research for Diabetes limitations

Current stem cell research faces some limitations that need addressing:

• Sample Size: Many clinical trials have had small sample sizes due to the novelty of stem cell therapies, hindering definitive conclusions about long-term efficacy.

• Need for Larger Studies: Phase III studies with more patients, multiple doses of MSC injections, and longer follow-ups are essential to understand MSCs' therapeutic effects in Type 1 Diabetes and the molecular mechanisms involved.

These steps are crucial for advancing our knowledge and application of stem cell therapies.

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What is Type 2 Diabetes?

Type 2 diabetes (T2D) is a chronic condition characterized by high blood sugar levels due to the body's inability to use insulin properly. Insulin is a hormone that regulates the absorption of sugar from the bloodstream into the body's cells for energy.

In type 2 diabetes, either the body does not produce enough insulin, or the cells do not respond appropriately to insulin, leading to a buildup of sugar in the blood. This can lead to various health complications over time if left untreated.

Type 2 diabetes is the most common form of diabetes, usually appearing in adulthood, and is closely associated with obesity and lifestyle factors such as poor diet and lack of physical activity.

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Is there a cure for Diabetes?

There is currently no cure for Diabetes.  Challenges to finding a cure for diabetes have primarily revolved around finding a method to replace or replenish b-cells.  In the past, the most effective treatment was a b-cell transplant to increase the number of healthy b-cells in a patient.

However, this procedure was undesirable for a multitude of reasons. The minimal number of b-cells required for a single transplant required 2-3 healthy donors. Additionally, the regimen of immunosuppressive drugs needed to prevent the body from rejecting the donor cells was strenuous for the recipient.

Can stem cells treat Diabetes?

Researchers are now turning to stem cells to achieve a high number of new b-cells without the adverse effects of a transplant. After being introduced into a patient, the stem cells migrate to the damaged tissue, differentiate into new b-cells, and maintain a healthy level of b-cells in the body.

Alternatively, stem cells can be lab-grown and induced into becoming insulin-producing cells. These cells could then directly replenish depleted cells in a patient's body. With these methods, Type 1 diabetes could be successfully managed without the limited supply of donor cells.

Stem cells can be used similarly to treat Type 2 Diabetes. Although b-cells are still present in Type 2 patients, additional b-cells could supplement the body's supply to overcome the insulin resistance present in a patient. Treatment could aim to continuously maintain B-cell levels above the required amount to combat a patient's insulin resistance.

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Conclusion

Stem cell research in diabetes treatment is showing promise, particularly in improving glucose control and reducing insulin dependency. Key insights include:

• Dosage and Timing: Success depends on the target dose and timing of treatment. Early intervention with higher stem cell doses may yield better outcomes than lower doses or delayed treatment.

• Types of Stem Cells: Mesenchymal stem cells (MSCs) are gaining attention as a safer, practical diabetes therapy option due to their immunomodulatory properties and low tumorigenicity risk.

As regenerative medicine advances, it's crucial for researchers and medical officers to refine stem cell dosing and timing and investigate new cell types like MSCs. This research aims to transform diabetes management by replacing lost insulin-producing cells, offering a practical approach to chronic disease management and potentially enhancing the quality of life for those with diabetes.

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References

(1) Jayasinghe M, Prathiraja O, Perera PB, Jena R, Silva MS, Weerawarna PSH, Singhal M, Kayani AMA, Karnakoti S, Jain S. The Role of Mesenchymal Stem Cells in the Treatment of Type 1 Diabetes. Cureus. 2022 Jul 27;14(7):e27337. doi: 10.7759/cureus.27337. PMID: 36042996; PMCID: PMC9414788.

(2) Maahs DM, West NA, Lawrence JM, Mayer-Davis EJ. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am. 2010 Sep;39(3):481-97. doi: 10.1016/j.ecl.2010.05.011. PMID: 20723815; PMCID: PMC2925303.

(3) Izadi, M., Sadr Hashemi Nejad, A., Moazenchi, M. et al. Mesenchymal stem cell transplantation in newly diagnosed type-1 diabetes patients: a phase I/II randomized placebo-controlled clinical trial. Stem Cell Res Ther 13, 264 (2022). https://doi.org/10.1186/s13287-022-02941-w