A few diabetics have been able to give up their daily insulin shots after getting transplants of pancreas cells, according to the broadest study of this experimental treatment. But for most patients, the results fell short of the cure researchers have been seeking.

Nearly half of the 36 patients who received the cell transplant achieved insulin independence by one year after the treatment. The benefits were mixed for the others, and about three-quarters of the whole group relapsed and needed insulin injections again.

The patients had severe cases of Type 1 diabetes, the less common form once known as juvenile diabetes, which is not linked to obesity.

Experts said the treatment, involving pancreas cells from donated cadavers, holds promise and they believe it won’t be long before doctors figure out how to extend the benefit to more diabetics. Researchers, reporting their findings in Thursday’s New England Journal of Medicine, said they did not know why it worked in some people and not others.

“For a select few, this represents a major alternative in their quality of life,” said Dr. Robert Goldstein, chief scientific officer for the Juvenile Diabetes Research Foundation International.

The only way for diabetics to receive a pancreas cell transplant is to enroll in an experiment. The treatment is not yet available at U.S. hospitals.

About 5 percent to 10 percent of the world’s 170 million diabetics have Type 1. The condition occurs when the pancreatic cells that make insulin, a hormone, are destroyed and can no longer produce it. The other form of diabetes, Type 2, is linked to obesity and occurs when the body can’t properly use the insulin it makes.

Type 1 diabetics need regular insulin shots to survive. Insulin is required to convert sugar from food into energy. Although some patients have pancreas transplants, the procedure is often risky.

For years, doctors tried to perfect a less-invasive technique that involves transplanting pancreas cells from cadavers into patients. The procedure proved disappointing until 2000 when a group of Canadian researchers led by Dr. James Shapiro of the University of Alberta published a landmark study in the New England Journal that detailed a more efficient way to transplant cells into eight diabetics.

The latest study by Shapiro, which was partly funded by the U.S. government, is the first international and most extensive study of the treatment to date. It involved 36 Type 1 diabetics at nine hospitals in North America and Europe.

The patients suffered from a complication that prevents them from recognizing when they have low blood sugar. If untreated, the condition can cause loss of consciousness, a coma or even death.

In the study, 16 of the patients had completely reversed their diabetes a year after the transplant, 10 showed some benefits and 10 had none. Of those who were able to give up insulin shots, five were able to go for two years; 16 of those who got some benefit needed shots again within two years of the transplant.

As with other transplants, the patients must take medication for the rest of their lives to prevent rejection by their bodies.

Researchers reported 23 serious cases of side effects among cell recipients, including anemia, diarrhea and nausea. Eighteen cases required hospitalization.

“The question is, ‘Is this really for prime time?”‘ said Dr. Jonathan Bromberg, a professor of gene and cell medicine at Mount Sinai School of Medicine in New York City who had no role in the study. “The reality is that the chance of curing people still is quite slim.”

The study was funded by the Immune Tolerance Network, an international consortium headquartered at the University of California, San Francisco. The network is supported by branches of the National Institutes of Health and the Juvenile Diabetes Research Foundation.

The findings mirrored those from a previous study Shapiro published last year on 65 patients at his hospital, which found that a few maintained insulin independence after five years.

On the Net:

New England Journal of Medicine: http://www.nejm.org

American Diabetes Association: http://www.diabetes.org

Juvenile Diabetes Research Foundation: http://www.jdf.org

AP-ES-09-27-06 1552EDT

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