Treatments for Diabetes

	Islet Transplants Pancreas Transplants Self-Management Diabetes Research at the University of Minnesota

Diabetes is treated differently depending on whether it is type 1 diabetes or type 2 diabetes.

Type 1 Treatment

People with type 1 diabetes must take insulin shots or have a transplant to replace their non-functioning beta cells in order to survive. People with type 1 diabetes work with their diabetes care team to determine the number of shots, the type(s) of insulin, and the timing of the shots. It is important to find an insulin routine that keeps your blood sugar near normal and fit your lifestyle. People with type 1 diabetes typically start with two injections per day and commonly progress to 3-4 shots (or a pump that provides continuous insulin) per day. There are nearly as many insulin regimens as there are people with diabetes and it is important to work with your diabetes care team to keep your blood sugar as close to normal as possible. Studies have shown that 3 or 4 injections per day can improve blood sugar control and prevent or delay the eye, kidney, and nerve damage that diabetes can cause.

The pancreas contains beta cells, which are the body's only cells that make insulin. Insulin is a hormone that is necessary to allow cells to convert glucose to energy. When food is consumed, beta cells release the precise amount of insulin needed over the correct period of time to convert carbohydrates and glucose into energy for use by the body. People with type 1 diabetes no longer have functioning beta cells; these cells have been mistakenly attacked and destroyed by their own immune system.

Since the discovery of insulin in 1922, people with diabetes have had the ability to inject insulin to compensate for the fact that their own pancreas no longer has insulin-producing cells. Over the years, many new types of insulin and injectibles have been developed, allowing people with diabetes to tailor their diabetes management. Your physician and diabetes care team will help you determine the appropriate amount and type of insulin or injectible you need to effectively manage your blood glucose levels.

People with type 2 diabetes may need insulin injections or oral medications to lower their blood sugars. Some people with early type 2 diabetes can improve their blood sugar by exercising and/or losing weight. It is important to work with your diabetes care team to keep your blood sugar as close to normal as possible in order to prevent or delay the eye, kidney, and nerve damage that diabetes can cause.

Transplantation

Another option for treating diabetes is transplantation to replace the nonfunctioning beta cells. Replacing these cells with healthy transplanted ones restores the body's ability to produce insulin, and for many people, has enabled them to reduce their need for insulin shots or eliminate them altogether.  Currently, there are two types of transplants.

The first is a pancreas transplant. Of the approximately 21,000 pancreas transplants performed throughout the world, about 15,000 have been done in the United States. The University of Minnesota has performed almost 1,700 pancreas transplants, over 10% of all transplants done in the United States. 

The second type is an islet transplant.  Islets (pronounced "eye-lets") are cell clusters located in the pancreas. Beta cells are the most abundant islet cells, they are the only cells in the body that make insulin. Alpha cells make glucagon, which is another hormone that affects the amount of glucose in the bloodstream. Delta cells make yet another hormone called "somatostatin." People with diabetes still have islets, but the beta cells have been destroyed.