21 years after diabetes breakthrough, U of A researcher says better treatment within reach

Thanks to the work of Edmonton researchers, thousands of people with Type 1 diabetes around the world have received life-changing treatments.

Nina Greene is among them.

Four years ago, the RCMP showed up at her home in Fort McMurray, Alta., urging her to contact the University of Alberta Hospital in Edmonton. 

Greene, who was diagnosed with Type 1 diabetes in 2003 and had struggled for years to manage it, was on a waiting list for an islet cell transplant — a procedure that could put an end to her fluctuating blood sugar levels and frequent hospital visits.

She had been warned to keep her phone close in case donor cells became available, but after months of waiting, she had turned it off for one night — the night her turn came. She called the hospital and was told to go there as soon as possible.

After driving through the night to Edmonton, she received an injection of pancreatic islet cells in her liver.

The short procedure worked. Greene still takes anti-rejection drugs so her body does not reject the donor cells, but she no longer takes insulin because the islet cells produce it. 

"Every night, I pray and thank the U of A Hospital for giving me a second chance at a better life," she told CBC News.

Future treatment

Researchers at the U of A pioneered the treatment Greene received — dubbed the Edmonton Protocol — in 2000. Twenty-one years later, the transplant team recently performed its 700th islet cell infusion in Edmonton. The procedure has been replicated around the world, used to treat approximately 3,000 people. 

Rather than celebrate the achievement, the researchers behind the breakthrough are focused on the future.

Dr. James Shapiro, a U of A surgery professor who leads the Edmonton Protocol team, said researchers are grappling with two big challenges: lessening or eliminating the use of anti-rejection drugs and developing therapies that could potentially turn stem cells into islet cells. 

"Five or 10 years from now, I think the standard treatment for diabetes, Type 1 and possibly Type 2 as well, will be a cell transplant and not these other kinds of therapies that patients struggle with every day," Shapiro said in an interview with CBC Edmonton's Radio Active on Monday.

• Canadian professor gaining recognition for role in discovering insulin 100 years ago
• Edmonton VR software helps diabetes patients learn about vision loss

Though the Edmonton Protocol has been successful for patients with difficult-to-control diabetes, it is not a cure for the disease, Shapiro said.

For one, there are not enough donor islet cells for the millions of people who need them. 

And because islet cells are moved from one person to another, recipients like Greene must take anti-rejection drugs for the rest of their lives. These immunosuppressive drugs can come with side effects and a higher risk of certain cancers and infections, Shapiro said.

Shapiro and his colleagues are trying to change Type 1 diabetes patients' own blood cells into insulin-producing cells that could be returned to them. If successful, this treatment could remove the need for anti-rejection drugs altogether.

"It's a big journey to get from where we are now to that point, but it's well within our reach," he said.

The Diabetes Research Institute Foundation Canada (DRIFCan) has raised more than $1 million over the past year to support this research, but the team seeks an additional $22 million.

"We've got a lot of work and effort ahead of ourselves if we want to really accelerate this research, but they've been an immense help to us," Shapiro said.