Clinical study of the month. Prolonged insulin independence after transplantation of islets of Langerhans in a patient with type 1 diabetes: achievement of a dream?

peer reviewedA Canadian research team recently reported a series of 7 consecutive patients with type 1 brittle diabetes who could achieve sustained excellent metabolic control in the absence of insulin therapy after successful islet transplantation. This exceptional success, which contrasts with previous less favourable results, is probably due to the transplantation of a higher number of islets of good quality and to the use of a new glucocorticoid-free immunosuppressive regimen. These remarkable results which provide proof of the principle that islet transplantation can be reproducibly successful, at least for one year, may raise new hope in patients with type 1 diabetes. However, the problem of supply and demand of islets is huge and will require a careful, and probably difficult, selection of the best candidates to benefit from this new therapeutic approach