TUESDAY, April 14 (HealthDay News) -- In a Brazilian study, autologous nonmyeloablative hematopoietic stem cell transplantation (HSCT) successfully weaned 20 of 23 newly diagnosed type 1 diabetes mellitus patients off insulin and restored good glucose control, according to a study in the April 15 issue of the Journal of the American Medical Association.
Carlos E. B. Couri, M.D., of the University of Sao Paulo in Ribeirao Preto, Brazil, and colleagues recruited 23 patients (aged 13 to 31 years) diagnosed with type 1 diabetes mellitus from November 2003 to April 2008. Before and following HSCT, C-peptide levels were measured using mixed-meal tolerance tests, and investigators observed changes in insulin requirements and serum levels of hemoglobin A1c.
During follow-up (mean, 29.8 months), 20 patients not on corticosteroids, and without past ketoacidosis, became insulin free, the researchers report. Twelve of the patients remained insulin free for a mean of 31 months, while eight patients relapsed, necessitating the resumption of low-dose insulin. Of those who remained insulin free, hemoglobin A1c levels were less than 7 percent and the mean area under the curve of C-peptide levels increased significantly. In the temporarily insulin-free group, C-peptide levels also increased, and two of the eight patients eventually became insulin free again, the authors report.
"We showed that 20 of 23 patients became insulin free (12 continuously and eight transiently) for periods as long as four years associated with good glucose control and acceptable incidence of adverse effects," the authors write. "At the present time, autologous nonmyeloablative HSCT remains the only treatment capable of reversing type 1 diabetes mellitus in humans."
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