Development of β-cell Lines for Transplantation in Type 1 Diabetes Mellitus

For the better part of the 20th century, people with insulin-dependent (type 1) diabetes mellitus (IDDM) have relied on insulin administration as a life-saving treatment. However, periodical insulin injections are a crude substitute for the fine-tuned regulation of insulin release from the pancreatic islet β-cells, which is continuously and accurately adjusted to changing physiological conditions. As a result, most IDDM patients are exposed to episodes of hyperglycaemia and hypoglycaemia, leading to the development of severe complications. Modern diabetes research has two major goals: the first is to understand the aetiology of the disease sufficiently to be able to identify individuals at risk for developing IDDM and to intervene to prevent it. The second goal is to replace β-cell function in people who already have developed the disease with a safe, efficient, and convenient treatment that will prevent the complications of IDDM. This chapter summarizes the state of the art in the development of new approaches for β-cell replacement and evaluates the potential of cell therapy for treatment of IDDM.