New treatment options for type II diabetes

Type II diabetes mellitus is a disease with an incompletely elucidated nature, in which the
cells of all tissues and organs in which insulin receptors are present stop responding to
insulin, thus the blood glucose level constantly remains above normal. This condition is
pathological, and it causes disturbances in peripheral tissues and vessels. Frequent
consequences are:

• Nephropathy is a violation of filtration in the kidneys due to lesions of the renal vessels,
  the result of which is renal failure;
• Retinopathy is a violation of blood circulation in the vessels of the retina, which leads to
  a decrease or complete loss of vision;
• Limb ischemia — a violation of the normal function of blood vessels leads to a lack of
  oxygen in the limbs, and, consequently, to a cooling of the limbs, a decrease in sensitivity,
  and in more severe cases — to the appearance of ulcers and even amputations of fingers or limbs.

In addition, patients with diabetes mellitus are regularly at risk of hypoglycemia or
hyperglycemia these are states when the level of glucose is too low or too high what makes a danger for patients live.

Risk factors for the development of diabetes mellitus are genetic, overweight, decreased
motor activity. Despite the fact that lifestyle changes significantly reduce the risk of
developing the disease, risk factor management does not allow avoiding diabetes mellitus
or reliably predicting which group of patients it will occur and what its severity will be.

The standard methods of treating diabetes mellitus are diet, drugs that reduce blood sugar
levels and insulin injections. All these measures lead to a partial result, but not to a full
recovery or to the possibility of avoiding restrictions in life.

Stem cell therapy has become widespread in recent years.

Stem cells make it possible to achieve cellular regeneration in a natural way. When stem
cells are exposed to the body, the cells capable of receiving insulin become the same as
similar cells in younger patients, and, accordingly, perform their functions in this way as
younger cells.

The possibilities of cellular recovery depend on the degree of the disease and on the type
of stem cells.

Stem cells are divided into several types.

• Mesenchymal cells from their own blood — these stem cells are isolated mainly from
  venous blood (in elderly patients, this sometimes requires bone marrow puncture). Suitable for patients who do not want to use non-native stem cells. This method is the cheapest and absolutely safe, since the treatment uses those cells that are already in the patient’s body.
  There are no such undesirable phenomena as transplant rejection for such treatment. Such stem cells are currently not associated with an increased risk of cancer.
  They are indicated by patients with mild stages of the disease.
• Mesenchymal stem cells from adipose tissue are also isolated from the patient’s own tissue and can be combined with aesthetic cosmetic procedures. They allow you to get more stem cells than from blood cells, but this requires taking more material.
• Multipotent stem cells that are derived from the neural crest are human stem cells in the
  early stages of differentiation. These stem cells are cell cultures, so they do not need to be
  obtained from the patient’s body, which is an important factor for elderly and weakened
  patients, as well as patients with severe vascular lesions that do not allow them to
  withstand a long procedure on an apharetic apparatus. Such stem cells are intended for
  patients who need insulin injections, in this case, the patient’s own stem cells do not have
  much chance of significantly improving the patient’s condition.
• Mesenchymal stem cells (umbilical cord MSCs) — the patient’s own cells can be used if the
  patient’s umbilical cord blood was preserved at birth. In other cases, cells from cell culture
  are also used. These cells are the most effective inducer of cellular regeneration and, as a
  result, the most effective type of treatment for type II diabetes mellitus. They are
  prescribed in the most severe cases of the disease. However, this type of treatment is most often worse tolerated (fever, chills, nausea, muscle pain, weakness and fatigue), and also most often causes graft rejection reactions. Most often, the first stem cell transplant
  procedures take place in a hospital setting.

How are stem cells taken?

The mechanism of treatment consists of the following stages. Venous blood is taken from
the patient (in rare cases, bone marrow). If venous blood is used for sampling, an apheresis apparatus is used for the procedure. To do this, the patient is fitted with an intravenous catheter. The catheter has a cannula (septum) in it, which allows you to separate the blood flows — the blood that leaves the patient’s body goes to the stem cell isolation apparatus, and the blood that has already passed the stem cell isolation process returns to the patient’s body through another opening of the same catheter. When the patient’s blood enters the apheresis apparatus, the blood used is centrifuged, which makes it possible to separate its shaped elements, and passes immunological methods of isolating stem cells. Stem cells are placed in liquid nitrogen and stored at a temperature of 150 degrees. If it is necessary to inject these stem cells back into the patient’s body, they are either injected in a concentrated manner into the necessary area or organ (by injection into an artery that supplies blood to the corresponding organ) or, as in the case of diabetes mellitus, into the general bloodstream. If stem cells are injected into the patient’s blood supply system, most likely, before being injected into the patient’s body, hematopoietic factors — drugs that will cause stem cells to divide and thereby increase the number of stem cells — will be required to influence stem cells.
In the case of taking stem cells from adipose tissue, the material for isolating stem cells is
taken using a special needle with a large cannula under local anesthesia.

What examinations are required for the patient before transplantation?

• The patient is required to undergo standard examinations:
• General blood test;
• General urine analysis ;
• Coagulogram;
• General analysis of blood sugar, glycosylated hemoglobin indicators;
• Biochemical blood analysis;
• Immunogram;
• General examination of the doctor before the procedure.

If necessary and in the presence of complications, additional tests may be prescribed to the patient.

Are there any contraindications to stem cell transplantation?

The procedure is not carried out:

• Patients with oncological diseases with remission less than 3 years (the exception is
  autologous stem cell transplants in hemoblastosis);
• Patients with decompensated diabetes mellitus before prescribing an adequate dose of
  insulin and undergoing a course of insulin therapy with regular intake of the required
  amount of hormone until the condition stabilizes;
• During acute myocardial infarction and stroke;
• During acute respiratory diseases.

Are there any age restrictions regarding stem cell transplantation?

No, but the age of the patient affects the choice of the type of stem cells. Children and
young patients will most likely be assigned their own stem cells, elderly patients will be
given culture cells if they do not have their own stem cells stored in a cell bank.

How safe is the procedure?

The procedure can cause deterioration of the patient’s condition and rejection reactions, no serious health consequences have been recorded.

How effective is stem cell transplantation?

Some patients manage to completely get rid of insulin injections, most patients become
able to reduce the dosage and stop vascular side effects.

How many procedures are required to complete the course of treatment?

It depends on the selected cell type, the patient’s condition and the patient’s response to
treatment. On average, from 2 to 5 procedures are required, but only the doctor can tell
how much a particular patient will need after examinations. The interval between
injections is 2.5-3 weeks.