Ciro Gargiulo, Van H Pham, Huynh D Thao, Nguyen CD Kieu, Melvin Shiffman, Mark J Holtherman, Sergey K Aityan
Background: The use of autologous peripheral stem cell (PB-SCs) in Diabetes Mellitus type 1 (type 1 DM) was described in 2007 with promising conclusion. However a similar treatment with a positive outcome on type 2 diabetes mellitus patients (type 2 DM) has not been yet reported. The goal of this study was to determine the effect of combination of autologous PB-SCs transplantation and low glycemic index diet (LGI diet) in treatment of DM2 patient.
Methods: Current study involved 13 patients with type 2 DM (aged 48 to 84 years) during a period of 180 days in our facility in Ho Chi Minh City Vietnam. Clinical variables (duration of DM, oral hypoglycemic drugs, time free from oral drugs) and laboratory variables (HbA1c, blood pressure, weight, cholesterol), mononuclear cells infused were assessed. Purified PB SCs were infused into major systemic vein (upper limbs or lower limbs) and subcutaneously in the abdomen. Follow-up is performed weekly after infusion during a period of 6 months.
Results: Mean HbA1c values showed a significant reduction during follow-up in all patients after autologous PB-SCs. After the treatment with stem cells the HbA1c level dropped by at least one unit relative to the HbA1c level in the medication phase, with stem cells patients have mean value of HbA1c lower than 6.5% (Mean value at time of diagnose 8.9%, at time of medication 7.9% and at time of post stem cell therapy 6.2%). Also, it was confirmed that the stem cell treatment is more efficient for the patients with higher HbA1c level in the medication phase and the level originally diagnosed. In 180 days after the combined therapy,HbA1c, cholesterol, and liver profile stay stable compare to the baseline among those patients who did not continue the LGI diet. All patients were insulin and/or oral hypoglycemic drugs completely free.
Conclusions: Combined therapy of autologous PB-SCs and LGI diet treatment can improve glucose control and reduce the dose of insulin and/or oral hypoglycemic drugs in type 2 DM patients, but it only improve pancreatic β-cell function transiently if the patients would not continue the LGI diet. Further randomized controlled clinical trials involving more patients will be required to confirm these findings and the mechanism needs to be learned deeply.
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