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Diabetes

Finding Clinical Trials for Diabetes

05/29/2007

Question:

I have been researching the islet cell transplant and trying to find a place that will accept me for over a year now. When UC had offered it a few years ago they said I didnt have enough complications to be in the trials for their hospital. I have had diabetes since I was 13 months and am going to be 25 in September. I have minor kidney damage, small problems with my vision, and small amount of neuoropathy. I want to try to get in these studys and hopefully get something done before to many complications come up. My bloodsugars have been ranging about 250 to 60, sometimes up to 300, which seems high but is a lot more under control than it has been for over 5 years. I have tried changing my diet, and exersice and eating the same things but the only thing that has seemed to work at all it giving frequent booster shots to even out my meals. I quit smoking to try to get the clinical trial but still I cant find any luck on getting straight anwsers on where to apply or even if I am eligible to get it done. I am willing to travel and an willing to pay for it if I have to. Please give my some direction on what to do or where I can go before it may be to late.

Answer:

There are several dimensions to responding to your question:  One is to answer your direct question about where to find transplant programs that might include you in an islet cell transplant study.  The other major dimension is to make sure that you realize what you would be getting yourself into if you were to participate in such a study.  With regard to the first question, I suggest you contact the transplant center with whom you had previous contact - they would know what other centers are available that are performing transplants these days in people with type 1 diabetes, what their track records are and the criteria they are using for selection of subjects.  In terms of the question of whether you understand what you are getting yourself into, I am concerned from what you write that you may be open to undertaking a transplant without full discussion and understanding of not only potential benefits but also potential risks.  There was a great deal of enthusiasm for islet cell transplants several years ago because of some well publicized good results.  However, those results in limited centers have not been matched generally throughout the US and the world, and the pace at which islet cell transplants are being performed has slowed.  Keep in mind that diabetes is "for keeps" and that when you are looking for a form of therapy that you consider whether that therapy has a suitable likelihood of success and small enough risk that you are not taking on long-term risk for short-term gain.  This still constitutes an experimental form of therapy with relatively little long-term evidence concerning benefits and risks.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati