Diagnosis:

Recently-revealed diabetes mellitus type 1, severe form, decompensated, diabetic ketoacidosis.

Male patient P.I.N., born in 1960, was admitted to the Department of Diabetes of the Research Institute for Endocrinology and Metabolism on November 6, 1991, with complaints of general weakness, loss of weight, xerostomia, polydipsia, and pollakiuria. The patient considers himself sick since September, 1991 when such complaints appeared for the first time. The patient has been never examined. Rapid aggravation of the patient’s condition urged him to apply for medical aid in November, 1991.

Diagnosis: Recently-revealed diabetes mellitus type 1, severe form, decompensated, diabetic ketoacidosis.

On admittance, the level of blood glucose was 15 mmole/l; glucosuria, 41.6 g/l; acetonuria, (+++). The following treatment has been prescribed: insulin: 60 units/day; vitamin therapy; potassium preparations.

Upon achievment of compensation, on December 2, 1991, first treatment was carried out (sample 3038c-63HL): nucleated cells count 36.2*10⁶/ml; CFU GM 23.6*10⁶/ml; CFU GEMM 2.5.10³/ml; CD34 1.4.10⁶/ml. Method of administration was intravenous. The amount of administered cells versus the total tissue weight of the given sample stored at the cryobank, was 66 %.

The patient well tolerated the treatment. On the first day, syndrome of early posttransplantation improvement was observed: decrease of weakness and improvement of appetite, the patient became more swift and active.

Three weeks after treatment, hypoglycemic states appeared, causing gradual decrease in the daily dosage of insulin administration; the maximum decrease was observed after 2.5 months (Table 1).

Normalization of immune tests was observed as early as on the 11th day (Table 2). During six months after the initial treatment, the patient was in the compensated state with a stable and relatively low daily dosage of administered insulin.

At the end of May, 1992, the patient’s state sharply aggravated: symptoms of decompensation of the carbohydrate metabolism appeared, and immune tests worsened (Table 4). The daily dosage of administered insulin was increased up to 32 units.

On June 3, 1992, repeated treatment using the same sample of cell suspension (3038C-63HL) was carried out: 0.5 ml of cell suspension were administered. The patient thewell tolerated the treatment. Positive changes daily dosage of administered insulin and immune tests are shown in Tables.

Counts of erythrocytes containing fetal hemoglobin evidence the substitution effect of administered cells.

Head of the Cell Therapy Clinic of National Medical University and Center "EmCell"
professor Alexander Smikodoub.

Table 1

Parameters analyzed before and after treatment (in compensation) (P. I. N.)

December 2, 1991: 1st treatment

June 3, 1992: 2nd treatment

Table 2

Immunological tests (P.I.N.) in progress.