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Treatment of type I diabetes mellitus in patient P.I.N.

Male patient P.I.N., born in 1960, was admitted to Cell Therapy Center EmCell on November 6, 2001, with complaints of general weakness, loss of weight, xerostomia, polydipsia, and pollakiuria. The patient considers himself sick since September, 2001 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, 2001.

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, 2001, first treatment was carried out (sample 3038C-63HL): nucleated cells count 36.2x106/ml; CFU-GM 23.6x106/ml; CFU-GEMM 2.5x103/ml; CD34 1.4x106/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, 2002, the patient’s state sharply aggravated: symptoms of decompensation of the carbohydrate metabolism appeared, and immune tests worsened. The daily dosage of administered insulin was increased up to 32 units.

On June 3, 2002, repeated treatment using the same sample of cell suspension (3038C-63HL) was carried out: 0.5 ml of cell suspension were administered. The patient tolerated the treatment well. Positive changes in 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.

Table 1. Parameters analyzed before and after treatment (in compensation) (P. I. N.)
December 2, 2001: 1st treatment
June 3, 2002: 2nd treatment

Parameters 01.12.01 23.12.01 17.01.02 23.02.02 07.05.02 03.06.02 06.07.02 17.07.02 21.01.03
Prior to treatment
21st day after 1.5 months after 2.5 months after 5 months after 6 months after 1 month after 1.5 months after 7.5 months  
Daily dosage of insulin, units 48 36 20 20 20 32 24 22 24
Decrease of daily insulin dosage versus initial level, % 25 40 59 59 34 50 55 50
Erythrocytes containing fetal hemoglobin, % 0 18 12 14 8 2 12 18 14


Table 2. Immunological tests (P.I.N.) in progress.

Date 14.11.01 17.12.01 07.04.02 28.05.02 14.06.02
Parameters before treatment 11th day after 4 months after 6 months 11th day after 2nd treatment
T-lymphocytes, % 40 53 50 50 53
T-lymphocytes, 109/l 0.71 0.89 1.08 0.80 0.85
T-helpers, % 37 20 41 37 33
T-helpers, 109/l 0.53 0.49 0.79 0.59 0.53
T-suppressors, % 12 24 15 13 20
T-suppressors, 109/l 0.17 0.40 0.28 0.21 0.32
T-helpers/T-suppressors, % 3.1 1.2 2.7 2.85 1.7
B-lymphocytes, % 37 31 18 30 27
B-lymphocytes, 109/l 0.53 0.52 0.38 0.48 0.43
IgG, g/l 8.75 11.8 9.70 17.6 10.7
IgA, g/l 7.9 2.1 1.75 1.6 4.25
IgM, g/l 0.43 1.3 0.86 0.86 1.01

Fetal stem cells treatment results depend on: disease's severity, age of the patient, adherence for the medications and regime. Treatment results, presented on this site, are individual for each clinical case.