The American Diabetes Association (ADA) and the International Pancreas and Islet Transplant Association (IPITA) will host a joint symposium at the 84^th Scientific Sessions featuring a panel of experts who will discuss recent advances in beta-cell replacement therapy as well as current challenges facing researchers and clinicians.

The session, Joint ADA/IPITA Symposium—Clinical Beta-Cell Replacement Therapy Today, will be held on Friday, June 21, from 3:45 p.m. – 5:15 p.m. ET in Room W415B, the Valencia Ballroom, of the Orange County Convention Center.  The symposium will be livestreamed on the virtual meeting platform for registered meeting participants and will also be available on-demand following the meeting.

“Transplantation of beta-cells, whether islets or a pancreas, has been shown to dramatically improve glucose control and quality of life, and reduce complications such as severe hypoglycemia in type 1 diabetes; however, there are still treatment challenges and important hurdles that limit universal access to this therapy for diabetes patients,” said Michiel Nijhoff, MD, MSc, Endocrinologist and Researcher at the Einthoven Laboratory for Vascular and Regenerative Medicine at Leiden University Medical Center in The Netherlands.

Dr. Nijhoff will discuss challenges faced by clinicians in monitoring and treating transplant recipients for rejection or type 1 diabetes recurrence.

“Beta-cell transplantation is still performed with cadaveric donor cells and requires potent immunosuppression to prevent rejection,” he said. “However, these medications have downsides, and the clinician needs to achieve a balance between effectiveness and side effects.”

In a paper published last year, Dr. Nijhoff and colleagues described a model to diagnose beta-cell rejection without the need for biopsy and the options for treatment.

“Treatment does involve high-dose steroids, but it has been shown to be safe and efficacious as long as high-dose intravenous insulin is administered to counter the diabetogenic effects,” he said. “Essential to treatment success is timely recognition, so I would advocate for the use of glucose sensor technology in the first 24 months after transplantation so that occult hyperglycemia can be detected as early as possible.”

When it comes to evaluating patients with diabetes for beta-cell replacement therapy, advances in whole pancreas transplants or islet cell transplants and the potential for stem-cell-derived beta-cells as an alternative have influenced the indications and patient characteristics clinicians should be thinking about when considering treatment options, according to Anna Lam, MD, MSc, Assistant Professor in the Division of Endocrinology and Metabolism at the University of Alberta and Alberta Diabetes Institute in Edmonton, Canada.

“I think we need to broaden our view of who might benefit from these therapies. Traditionally, we’ve only thought of people who have problematic hypoglycemia, meaning severe lows or unstable, unpredictable glucose levels,” Dr. Lam said. “But I think there is a population of people who, despite medical optimization and despite using the latest technologies, are still experiencing a high burden of disease management and decreased quality of life who might benefit from beta-cell replacement therapies.”

She said clinicians must move beyond thinking about type 1 diabetes as simply a disorder of glucose metabolism.

“We need to not only assess and try to improve glucose control, but we need to be thinking about quality of life and trying to improve that and alleviate the burden of disease as much as we can for people living with diabetes,” Dr. Lam said.

Jane Speight, MSc, PhD, CPsychol, FBPsS, of Deakin University in Melbourne, Australia, will discuss the psychological impact of islet or pancreas transplantation, and Piotr Witkowski, MD, PhD, of the University of Chicago, will provide an update on clinical trials using stem-cell replacement.