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Patients with type 2 diabetes may benefit from stem cell transplants.

According to a study published in Stem Cells Translational Medicine under title “Type 2 Diabetes Mellitus Duration and Obesity Alter the Efficacy of Autologously Transplanted Bone Marrow-derived Mesenchymal Stem/Stromal Cells” type 2 diabetes patients who are not overweight and have had the disease for less than a decade can benefit from stromal stem cells transplanted from their own bone marrow.

Researchers from the Vinmec Research Institute of Stem Cell and Gene Technology in Hanoi, Vietnam, studied the safety and possible therapeutic efficacy of delivering bone marrow stromal stem cells to Type 2 diabetes patients in a randomized clinical trial. The cells were all autologous, meaning they came from the patients' own bodies.

A total of 30 adult patients were recruited for the trial, with varying BMIs and Type 2 diabetes histories ranging from one to 25 years. Each got two intravenous infusions or injections of the cells into an artery supplying blood to the pancreas.

The patients were observed for 48 hours before being re-examined at one-month, three-month, six-month, and one-year intervals. The patients' health did not appear to suffer as a result of the treatment, and they appeared to benefit similarly from both infusion procedures.

“Human bone marrow-derived mesenchymal stem/stromal cells (BM-MSCs) are a promising stem cell therapy for type 2 diabetes mellitus (T2DM), although autologous BM-MSC administration in T2DM patients has yielded mixed outcomes. “The goal of this study was to see if autologous BM-MSC administration in T2DM patients is safe, and if the treatment's efficacy is dependent on the quality of the autologous BM-MSC population and administration routes,” the researchers write.

”T2DM patients were enrolled and randomly assigned (1:1) to the intravenous and dorsal pancreatic arterial groups by a computer-based system. The efficacy was determined based on the absolute changes in hemoglobin A1c, fasting blood glucose, and C-peptide levels throughout the course of a 12-month follow-up in all of the treated individuals. In 30 T2DM patients, autologous BM-MSC injection was well tolerated, according to our findings. Patients with T2DM for 10 years and a BMI of 23 showed short-term therapeutic results, which is consistent with the phenotypic characterization of the autologous BM-MSC population. The length of T2DM affected the growth rate of BM-MSCs, stopped glycolysis and mitochondrial respiration, and caused mitochondrial DNA mutations to accumulate.

“Our findings imply that autologous BM-MSC therapy for T2DM should be used in individuals with T2DM for less than 10 years and no obesity. Future work with a larger cohort concentrating on individuals with diverse T2DM histories is essential to understand the mechanism underlying our result before further validating the impacts of T2DM on BM-MSC biology.”

Liem Nguyen, MD, PhD, the institute's research director, said, "Our patients tolerated the procedure well and showed short-term reductions in their blood glucose levels after the treatment." “We also discovered that some of them were able to reduce their diabetes medication dosage temporarily.”

Type 2 diabetes affects over 420 million people globally, accounting for around 90% of all diabetes cases and frequently resulting in disability or death. People with Type 2 diabetes are unable to make effective use of the insulin produced by their bodies. Some people can improve their condition by increasing their physical activity and eating a healthy diet, while many others need to use insulin or medications to keep their blood glucose levels under control.

Patients in the Vinmec research were divided into three groups based on which diabetes medications they were taking prior to receiving stem cell infusions. Some people relied only on insulin to keep their blood glucose levels in check. Others were using medications but not insulin, and still others were using both insulin and medications.

More over half of the patients were able to reduce their diabetes medication doses after receiving the treatment.

“Our study, which is the first to link the outcomes of autologous bone marrow stromal stem cell transplantation to BMI and Type 2 diabetes duration, demonstrates that the procedure is safe and pave the way for future clinical trials to investigate the potential benefits of this treatment in non-obese patients with Type 2 diabetes for less than 10 years,” Nguyen said.

Bone marrow stromal stem cells, also known as mesenchymal stem cells, are immune system cells that can change into connective tissue cells in any organ. They've become a versatile cell source in the field of regenerative medicine over the last 50 years.

“The results of this randomized clinical trial for patients with Type 2 diabetes and the injection of their own bone marrow stromal stem cells are encouraging, and could potentially add to the treatment arsenal for this chronic disease that affects so many people around the world,” said Anthony Atala, MD, Editor-in-Chief of Stem Cells Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine. “The short-term efficacy in patients with Type 2 diabetes for less than 10 years and a bone mass index of less than 23 is of particular relevance. This work paves the way for future research to delve deeper into this subject.”

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