The transplantation of pancreatic islet cells is the only known potential cure for type I diabetes, and in spite of many promising results in animal studies, it remains a highly experimental and costly operation for humans. In January 1994, DIABETES HEALTH spoke to Steven Craig, the first person to receive encapsulated islet cell transplants.
Craig underwent two separate surgeries, one in May of 1993 and one in November of 1993. Human islet cells, encapsulated in a semi permeable seaweed membrane, were inserted into his abdominal cavity by Patrick Soon-Shiong, MD of St. Vincent’s Medical Center in Los Angeles. At the time of our last report, Craig had a total of 1,080,000 functioning islet cells, only slightly less than the average healthy person, and his blood sugar highs and lows were dramatically reduced.
At the time, he was taking almost no insulin; however, he was still wary of overworking the newly transplanted cells, and he still carefully monitored his diet and tested his glucose levels eight times a day.
It has now been over two years since Craig’s initial surgery, and he feels that his progress has been phenomenal. To date, there have been no problems with the transplant and only positive surprises.
The improvements Craig felt during the first year have not declined. His glucose levels are still under control; his stamina and night vision are dramatically better; and he has experienced a 400% improvement in his neuropathy. Craig is now able to take six-mile walks, and he is working hard in the Nashville country music industry. He has an “unrestricted diet” but Craig admits, “After 31 years of being a diabetic, I don’t really care for the sickeningly sweet stuff anymore.”
He is due for another transplant some time this year. Craig explains that since the first two transplants contained only partial doses of islets, the cells have been overworked. Some days he takes small doses of insulin to give the cells a rest, but many days he is able to remain insulin-free. The next transplant he receives will contain a full dose of islet cells. (Soon-Shiong’s studies suggest that this is about 20,000 islets per kilogram of body weight.)
Craig believes he is a promising example of what research can do for people with diabetes, but he is the first to admit that there is a long way to go. The problems that must be surmounted are complicated.
Soon-Shiong’s recent setbacks have made evident several inadequacies in the research field. Currently, there is no formula to determine who gets the available pancreases, and according to both Soon-Shiong and Craig the distribution of the prized organs has become political. Craig is currently meeting with senators in an effort to establish a fair and equitable means of distributing funding and organs. He is also working on putting together a benefit project entitled, Through the Eyes of a Child , a childrens’ album containing songs by more than 12 big name artists. The proceeds will be donated to Soon-Shiong.
According to Craig, it has come down to whether scientists seek cures or simply money. Other islet cell researchers, who are presumably receiving the few available organs are “at least five years behind Dr. Soon-Shiong. If Dr. Soon-Shiong had the cells available, he would be able to move much faster in his trials.”
What is the outlook for people with diabetes? Craig foresees a “future brighter than the sun.”
But he adds, “First, people need to get mad.” Otherwise, possible cures will be slowed and eventually lost to the “selfish nature of those who want to block the research of others.”