Pancreatic Islet Transplant - Day 14 - Roger Sparks

Day 14 – Still No Insulin Needed

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At day 14 after my second Islet Transplant at the City of Hope, I still require no external insulin.  Recovering well, I’m starting to believe what is happening may really be true.

Day 14 – Absorbing The Results

Each day brings more surprises:

  • I’m requiring no insulin.
  • I have normal blood sugars.
  • I eat normal meals.
  • I am no longer using my insulin pump, my constant companion for almost 25 of my 35 years as a Type-1 diabetic.
  • I go to bed with a 110-115 blood sugar, out of habit wake up at 2AM to re-check my blood sugar, finding it’s still the same, and wake up in the morning with anywhere from an 85 to 100.
  • I’ve had no – zero – low blood sugar episodes since my first transplant on January 1, 2016.

What This All Means

To understand what this all means, we must go back to the stated objectives of this clinical trial, and to evaluate the results I have obtained so far.  City of Hope’s stated objectives for this trial are:

  • to evaluate the safety and effectiveness of islet transplantation using an immunosuppression drug called anti-thymoglobulin (ATG) to prevent islet transplant rejection, when used in combination with other immunosuppression drugs.
  • To evaluate how your body responds to transplanted islets.
  • To determine the quality of life of research participants receiving islet transplantation.

Primary Outcome Measures (all of which I am achieving 100% at this time):

  • Proportion of subjects who are insulin independent, hypoglycemia free, AND with hemoglobin A1c ≤ 6.5%

Secondary Outcome Measures (all of which I am achieving 100% at this time):

  • Reduction/Elimination of hypoglycemia

Other Outcome Measures (most of which are still pending for me, and that will be evaluated over the five year duration of this clinical trial):

  • Duration of insulin independence
  • Positive Stimulated C-peptide
  • Reduction in daily insulin requirement
  • Insulin secretion during Intravenous Glucose Tolerance Test
  • Rate of alloimmune rejection
  • Rate of autoimmune reactivation
  • Incidence and severity of adverse events related to islet transplant procedure
  • Incidence and severity of adverse events related to immunosuppression
  • Incidence of change in immunosuppression drug regimen
  • Incidence of immune sensitization defined by presence of anti-HLA antibodies post-transplant that were absent pre-transplant
  • Incidence of discontinuation of immunosuppression

Summary

So, since I am currently having very positive results, I’ve obviously been very, very lucky so far.

Remember that these are my results alone, and I have no idea how other transplant recipients in this clinical trial have fared, nor does it indicate how others may do in the future.  But it does give me great hope, and certainly an idea about the role that islet transplantation can play in a Type-1 diabetic’s life.

I very much believe that I am traveling on a road, and participating in a trial, that will lead to a cure – hopefully that I will see in my lifetime.

How long will this last for me?  Will I have any complications?  Are there difficulties ahead?  All very good questions, but right now they are just not so much on my mind.

As I asked before:  Has anyone ever had a better fourteen days?

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