New technique retrains organs to stop diabetes

December 28, 2009 9:43:55 AM PST
The pancreas is an organ that resides behind the stomach and is responsible for producing enzymes that help digest food, as well as the hormones insulin and glucagon. Chronic pancreatitis is ongoing inflammation of the pancreas, which causes inhibition of its normal functions. It may also interfere with insulin production and lead to diabetes. "The pancreas gradually with time becomes more and more scarred, and the normally healthy pancreas tissue gets replaced with scar tissue, and so the pancreas stops functioning normally, and these patients develop a very severe debilitating pain," Katy Morgan, M.D., associate professor of surgery at the Medical University of South Carolina in Charleston, S.C., explained to Ivanhoe.

Patients usually complain of abdominal pain, steatorrhea, or excess fat in stools, severe nausea, and unintentional weight loss. Most cases -- 70 percent -- are attributed to chronic alcohol use. Those patients will have often drink more than 150 g/day of alcohol for more than six to 12 years. Some cases may be due to gallstones while others have an undeterminable cause. In addition, a few patients may have inherited or developed a Sphincter of Oddi dysfunction (SOD). In children, the most common culprit of chronic pancreatitis is cystic fibrosis. Tests can reveal is a patient is suffering from the condition. A secretin stimulation test is often the preferred method of testing. Other tests used include faecal elastase measurement of stool, computed tomography (CT) scans, ultrasounds and MRIs.

TREATMENT: Pancreatic enzymes may be given to help with malabsoption of nutrients and steatorrhea. Analgesics can help relieve pain, and insulin may also be prescribed. When medications fail to help, however, many times patients are required to have al of part of their organ removed. This causes further complications, however. With no pancreas, the body is unable to produce insulin, automatically making the individual a type 1 diabetic.

TURNING THE LIVER INTO THE PANCREAS: Now there is also another option for patients who have not responded to other treatments. It's called an autologous islet cell transplant. For the procedure, the pancreas is removed in the operating room and taken to a laboratory where insulin-producing islet cells are removed from it. Then, an interventional radiologist inserts a catheter through the patient's upper abdomen and accesses the liver through its main blood vessel. The cells are delivered to the liver where the hope is they will stay and operate as a miniature pancreas, producing and releasing insulin. "So with islet autotransplantation, we're able to help at least prevent diabetes or at least make it a much lesser form that's easier to control," Dr. Morgan said.

FOR MORE INFORMATION, PLEASE CONTACT:

Heather Woolwine
Media Relations
Medical University of South Carolina
(843) 792-76690
woolwinh@musc.edu


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