Management of type 1 diabetes mellitus using in vitro autologous adipose tissue trans-differentiated insulin-making cells.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Type 1 diabetes mellitus (T1DM) is a result of autoimmune destruction of insulin-producing β cells of pancreas. Insulin is a widely used therapeutic modality. Nearing a complete century since the discovery of insulin, it is time to expect change in management strategies of T1DM. We report two men aged 22 and 15 years, respectively, with T1DM since 6 and 11 years, on exogenous insulin therapy of 64 and 56 International units (IU)/day respectively. We infused in vitro generated insulin-making cells trans-differentiated from donor adipose tissue derived mesenchymal stem cells and bone marrow-derived haematopoietic stem cells in their abdominal subcutaneous tissue, portal and thymic circulation under non-myeloablative conditioning. Over follow-up of 22.93 and 13.8 months they have stable blood sugar levels with glycosylated haemoglobin level of 6.3% and 6.8% with present insulin requirement of 18 and 22 IU/day, respectively.

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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