Scott King

January 19, 2000. A question by e-mail:

Hi Scott,

I am a 29 year old Type II diabetic. Originally diagnosed with 15%+ A1c(15 is as high as Kaiser measures).... and a 350 fasting glucose.....

Now my A1c is in the high 5's and has been there for over a year. I don't take any insulin. I have cobbled together a great nutritional program and take 4 mg Avandia and 1 glucophage everyday.

I love your company and watch it closely…
Will the implants you are working on also assist Type II diabetics who are progressed in their disease and no longer produce a viable amount of insulin?

Have a great day.

Mace

Scott's reply: We believe that the islet sheet will benefit any form of diabetes that includes insufficiency of insulin. This includes all type I diabetics, and any type II diabetic that is injecting insulin. Our initial clinical studies will focus on type I where the need (of what?) is greater.

January 17, 2000. A question by e-mail:

Hello I am a diabetic and have been a diabetic for almost 8 years now. I have a question concerning about the islet transplant. I read where human islet does work. Can a living human give "islet" donor? I read somewhere it has to be a dead person. The reason I am asking is because if this is possible I have relatives who would be willing to do this. And any recent information about islet transplant you can give me would be great!
Amy

Scott's reply: This is an interesting question. There are thousands of kidney donation each year, usually to relatives; why not pancreas islets? There is no reason the an islet donor cannot be living, because partial removal of the pancreas has been demonstrated. (The figure shows the pancreas; the tail at the right can be removed and the remaining head can make digestive juices and enough insulin And it happens that the tail is rich in islets of Langerhans compared with the head.)

But virtually all islet transplants are done with unrelated cadaver donor islets. There are several reasons for this. First, unlike kidneys, there is little evidence that islets from a family member a less likely to be rejected. Second, islet transplants rarely permit the diabetic to go off insulin. Removal of the pancreas from a relative significantly increases the chance of that person developing diabetes. Given the high failure rate, and the medical maxim "first do no harm," surgeons are just not willing to put the relatives at risk.

If the success of human islet allografts rises above 80%, as it might some day, surgeons would probably revisit the question of living related donors. But here at ISM we hope that islets from animals or grown in the laboratory will be possible.

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