1 34 Monitoring Stem Cell Research 
2. Current Therapy Choices and Outcomes. 
The current treatment of Type-1 diabetes consists of insulin 
injections, given several times a day in response to repeatedly 
measured blood glucose levels. Although this treatment is life- 
prolonging, the procedures are painful and burdensome, and in 
many cases they do not adequately control blood glucose con- 
centrations. Whole pancreas transplants can essentially cure 
Type-1 diabetes, but less than 2,000 donor pancreases become 
available for transplantation in the U.S. each year, and they are 
primarily used to treat patients who also need a kidney trans- 
plant. Like all recipients of donated organs, pancreas trans- 
plant recipients must continuously take powerful drugs to 
suppress the immunological rejection of the transplanted pan- 
creas. 
In addition to treatment with whole pancreas transplanta- 
tion, small numbers of Type-1 diabetes patients have been 
treated by transplantation of donor pancreatic islets into the 
liver of the patient coupled with a less intensive immunosup- 
pressive treatment (the Edmonton protocol ). Expanded clini- 
cal trials of this procedure are currently underway. Scientists 
are also evaluating methods of slowing the original autoim- 
mune destruction of pancreatic beta cells that produces the 
disease in the first place. 
Whole pancreas and islet cell transplants ameliorate Type-1 
diabetes, but there is nowhere near enough of these materials 
to treat all in need. To overcome this shortage, people hope 
that human stem cells can be induced — at will and in bulk — ^to 
differentiate in vitro into functional pancreatic beta cells, 
available for transplantation. Of course, it would still be crucial 
to prevent immunological destruction of the newly trans- 
planted stem cell-derived beta cells. 
3. Stem Cell Therapy for Type-1 Diabetes? 
Initial experiments in mice suggested that insulin- 
producing cells could be obtained from mouse embryonic stem 
cells following in vitro differentiation.^'* Can this approach be 
extended to human stem cells? A number of attempts have 
been made, with promising initial findings, yet they are not 
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