title: Combined therapy of insulin-producing cells and haematopoietic stem cells offers better diabetic control than only haematopoietic stem cells' infusion for patients with insulin-dependent diabetes.
abstract: Insulin-dependent diabetes mellitus (IDDM) is a chronic condition characterised by impaired blood sugar metabolism and autoimmunity. We report two children: a 5-year-old girl on exogenous insulin therapy of 30 IU/day and a 9-year-old boy on short-acting insulin 30 IU/day, long-acting insulin 70 IU/day, with IDDM since 4 and 7 years, respectively. We infused in vitro-generated donor bone marrow (BM)-derived haematopoietic stem cells (HSC) in patient 1 and insulin-secreting cells trans-differentiated from autologous adipose tissue-derived mesenchymal stem cells along with BM-HSC in patient 2 under non-myeloablative conditioning. Patient 1 improved during the initial 6 months, but then again lost metabolic control with increased blood sugar levels and insulin requirement of 32 IU/day; we lost her to follow-up after 18 months. Patient 2, over follow-up of 24.87 months, has stable blood sugar levels with glycosylated haemoglobin of 6.4% and present insulin requirement of 15 IU/day.
authors.affiliation: Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases & Research Centre (IKDRC), Dr. H. L. Trivedi Institute of Transplantation Sciences (ITS), Ahmedabad, Gujarat, India.
authors.forename: Shruti D
authors.initials: SD
authors.lastname: Dave
authors.affiliation: Department of Nephrology and Transplantation Medicine, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases & Research Centre (IKDRC), Dr. H. L. Trivedi Institute of Transplantation Sciences (ITS), Ahmedabad, Gujarat, India.
authors.forename: Hargovind L
authors.initials: HL
authors.lastname: Trivedi
authors.affiliation: Department of Paediatric Surgery, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
authors.forename: Saroj C
authors.initials: SC
authors.lastname: Gopal
authors.affiliation: Department of Transfusion Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Tulika
authors.initials: T
authors.lastname: Chandra
mesh_terms: D000273:Adipose Tissue; D001786:Blood Glucose / Q000378:metabolism; D002454:Cell Differentiation; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D050417:Insulin-Secreting Cells / Q000637:transplantation*; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin