Exploring views on current and future treatments for Type 1 Diabetes

Islet transplantation as a treatment for Type 1 diabetes

Type 1 diabetes (T1D) is an autoimmune disease in which the body’s immune system causes the destruction of insulin-producing beta cells in the pancreas. Insulin is a type of hormone, produced by pancreatic beta cells, and required for regulating glucose levels in the blood. People with T1D are dependent on treatment with exogenous insulin to control blood glucose levels. Some people with T1D have blood glucose levels that are difficult to manage and experience severe hypoglycaemia (low blood sugar) and may have hypoglycaemia unawareness, a dangerous condition in which a person cannot recognise the symptoms of hypoglycaemia. These people may be candidates for islet transplantation. In islet transplantation, islets, which are clusters of cells that contain insulin producing cells, are taken from the pancreas of a deceased organ donor and given to a person with T1D. The transplanted cells can help people to make their own insulin. Islet transplantation can improve blood glucose control, prevent severe hypoglycaemia, restore symptoms of hypoglycaemia, and reduce the need for daily insulin injections. Currently, there is a lack of published data on the views of people living with T1D in relation to their current treatments. Through participant engagement, future therapies and clinical research studies can be designed and conducted with people living with T1D in mind.

The PITCH study

The PITCH study, is a qualitative study of people living with T1D, led by Professor Shareen Forbes, Professor of Diabetic Medicine at the University of Edinburgh. During the study, participants with T1D, were interviewed either in person or via video link. The participants were divided into three groups, those post islet-transplant, those awaiting islet transplant and those with poorly controlled T1D, despite optimal therapy, or who are well controlled, but this has required a large amount of physical and/or psychological user input. The first section of the study involved a detailed discussion with the participant regarding their life with T1D. The second section concentrated on their views on islet transplantation. The participants were then sent relevant online questionnaires and asked to complete these at home in their own time. These results are currently being analysed. By engaging people living with diabetes, more relevant clinical research studies and future therapies that address people’s needs can be designed. Results from the PITCH study will enable health care professionals and others who are involved in the development of future treatments for T1D to implement decision making, focusing on the needs of the people living with type 1 diabetes.

In an age where we have seen advances in technology it is more important than ever to listen to the needs of people living with diabetes to understand how they feel about their treatment. It is not enough to focus on blood glucose targets we need to assess which treatments lessen the burden of living with the condition.

Professor Shareen Forbes