Islet transplants are not a routine treatment for type 1 diabetes. This might seem surprising as an islet transplant can mean that someone does not need to inject insulin for a number of years after their transplant.
This is because the risks of a transplant currently far outweigh the benefits of receiving one for most people with type 1. Like any transplant, an islet transplant means that the person who receives the new islets needs to take powerful drugs, called immunosuppressants, to stop their body from rejecting the new cells. The drugs are effective at doing this, but at the same time they reduce a person’s ability to fight off simple infections. People who have had islet transplants also return to needing insulin injections again after a few years, as the immunosuppressants do not stop the attack from the immune system that causes type 1 diabetes.
However the benefits of an islet transplant do outweigh the risks for people who have hypoglycaemia unawareness. Hypo unawareness is a condition where the person with type 1 gets no warning that their blood glucose levels are falling. If this awareness cannot be restored by using other glucose control strategies (like using a CGM or insulin pump) and islet transplant may be the best option for the person with type 1.
The UK NHS was the first health system in the world to offer islet transplants as a ‘routine’ treatment for hypoglycaemia unawareness.