Diabetes and stem cells

====================== **Diabetes and stem cells:** Due to the increasing trend of the prevalence of diabetes, especially in developing countries and the sedentary lifestyle and unhealthy diet, the need for new, effective and lasting treatment methods is felt more than ever. Common methods such as insulin injections or oral medications are mostly control and not curative. These approaches only manage the symptoms of the disease, while a definitive treatment to restore normal pancreatic function has not yet been found. For this reason, in recent years, medical science has been looking for more basic and innovative solutions that can lead to the root treatment of diabetes. Meanwhile, stem cell technology as one of the most promising areas of regenerative medicine science, attention It has attracted many researchers. Stem cells have an extraordinary ability to differentiate into all types of body cells, including pancreatic beta cells. This feature enables the regeneration of damaged or lost tissues and promises a revolution in the treatment of chronic diseases such as diabetes. The entry of stem cells into the field of diabetes treatment will be the beginning of passing from the temporary control stage to permanent and possible treatments for the complete recovery of patients. Why are stem cells suitable for the treatment of diabetes? Stem cells, as one of the newest and most advanced tools of medical science, have unique capabilities in regenerating and repairing damaged tissues. In diabetes, which has a chronic and progressive nature, the use of these cells can create a fundamental change in the course of treatment. There are three main reasons why stem cells are a promising option for diabetes treatment: regenerating pancreatic beta cells, reducing the need for insulin injections, and repairing other tissue damage caused by diabetes. 1-regeneration of beta cells in the pancreas: In type 1 diabetes, the body's immune system mistakenly attacks and destroys pancreatic beta cells. In type 2 diabetes, although beta cells are present, their function gradually weakens. These cells are responsible for secreting insulin, which is responsible for controlling blood sugar. One of the remarkable achievements in the field of stem cells is their ability to differentiate into functional beta cells. In many laboratory studies, researchers have succeeded in transforming stem cells into cells that produce insulin and can respond to changes in blood sugar like normal pancreatic cells. 2-reducing the need for insulin injection: Diabetic patients often have to inject insulin daily or multiple times, a process that is not only difficult and expensive, but also has a negative impact on their quality of life. Treatment with stem cells can restore the function of beta cells and as a result, the body will naturally secrete insulin. In some clinical trials, patients who were treated with stem cells were able to significantly reduce their insulin consumption. In certain cases, they even lived for a while without the need for insulin injections. This issue not only leads to better blood sugar control, but also reduces the mental pressure caused by drug dependence. 3- Repairing the damage caused by diabetes in other organs: Diabetes is not limited to high blood sugar. Over time, this disease can cause serious damage to different tissues of the body; including the kidneys (diabetic nephropathy), eyes (diabetic retinopathy), peripheral nerves (diabetic neuropathy), and blood vessels. Some types of stem cells, especially mesenchymal cells (MSCs), in addition to the ability to regenerate tissue, have strong anti-inflammatory effects and can be effective in healing these injuries. Preliminary research has shown that the injection of these cells can lead to improvement of kidney function, reduction of inflammation in nerve tissues, and even repair of chronic wounds in diabetic patients. Diabetes treatment methods using stem cells The progress of stem cell science in recent decades has opened new horizons for the treatment of chronic diseases, including diabetes. So far, several treatment methods based on stem cells have been investigated and tested to deal with diabetes. These methods are in the laboratory, animal and sometimes human stage and have brought some promising results. The three main methods of using stem cells in the treatment of diabetes are: Direct transplantation of stem cells to the pancreas: One of the first and most basic methods is the direct transplantation of stem cells to the pancreas. In this method, stem cells are injected directly or through veins into the patient's body to reach the damaged area (i.e. pancreas). These cells either differentiate into insulin-producing beta cells, or help repair existing beta cells by secreting growth factors and anti-inflammatory compounds. In some animal experiments, this method was able to cause a partial return of normal insulin production. The advantage of this method is that it can be done semi-invasively and does not require extensive surgery. However, challenges such as the lack of complete control over how cells differentiate, the risk of uncontrolled growth or tumor, and the possibility of rejection of cells by the immune system, still prevent its widespread use in humans. Production of human beta cells in the laboratory: One of the more advanced and accurate methods is the production of beta cells similar to pancreatic cells in a laboratory environment. In this process, scientists first grow embryonic or pluripotent stem cells in a controlled environment and, through biological manipulation, transform them into cells that function exactly like normal beta cells. These differentiated cells are then transplanted into the patient's body. Unlike the first method, in this method there is more control over the process of growth and differentiation of cells, so it carries fewer possible risks. In some human studies, after receiving these cells, patients have been able to maintain their blood sugar levels without insulin injections for several months. Also, in some projects, these cells are placed in biological capsules to protect them from the attack of the immune system and there is no need for immunosuppressive drugs. This encapsulation is considered an important development in the immunization of cell transplants. Use of induced pluripotent stem cells (iPSCs): One of the most revolutionary achievements of stem cell science are induced pluripotent cells or iPSCs. These cells are taken from normal body cells (such as skin or blood cells) and are returned to a powerful state through genetic changes; That is, a state similar to embryonic cells that have the ability to transform into any type of cell. The advantage of this method is the use of the patient's own cells. This means that the risk of immunosuppression is reduced and treatment can be personalized. iPSCs can be converted into beta cells and then used to regenerate the pancreas or produce natural insulin. Many biotechnology companies and research centers are focused on developing this method as a sustainable and safe treatment for diabetes. Despite many advantages, precise control of the differentiation process and prevention of abnormal cell growth are among the main challenges in this method. All in all, all three methods above are still in the research stage or clinical trials, but their progress is very fast. It seems that definitive treatment of diabetes, relying on stem cells, is no longer a far-off dream, but a path that is being realized. Advantages and challenges of using stem cells in the treatment of diabetes The use of stem cells in the treatment of diabetes promises a revolution in regenerative medicine. While current methods are mainly focused on disease management, stem cells can provide radical and long-term treatment. But like any new method, this method also faces advantages and challenges that will be examined in detail below. ### Advantages - **root treatment instead of temporary control:** The biggest advantage of stem cells is their ability to treat the main cause of the disease; It means the regeneration of insulin-producing beta cells in the pancreas. Unlike daily insulin injections that only control symptoms, stem cells can restore normal body function by repairing damaged tissue. - **Decreasing complications of diabetes in the long term:** With better control of blood sugar through the body's normal function, the possibility of complications such as kidney damage, blindness, chronic wounds and heart problems is significantly reduced. Some stem cells even have anti-inflammatory and restorative properties and can help to heal the damage caused in other tissues. - **Life without insulin dependence:** Many diabetic patients, especially those with type 1 diabetes, have to inject insulin frequently. Treatment with stem cells has revived the hope that patients can live without the constant need for drugs or injections, and their quality of life will improve. **Challenges** - **Probability of transplant rejection by the immune system:** One of the biggest challenges is the body's immune response to transplanted cells. The immune system may mistake these cells as foreign and destroy them, especially in people with type 1 diabetes whose immune system has previously targeted beta cells. The use of immunosuppressive drugs or iPSCs (from the patient) are ways to reduce this risk. - **High costs and limited access:** Stem cell treatments are currently very expensive. These costs include the process of extracting, differentiating, growing, storing and transplanting cells. Also, most of these treatments are in the research stages and are not yet widely and commercially available, which limits patient access. - **Ethical issues:** In some cases, especially in the use of embryonic stem cells, moral and Islamic issues are raised. Although this challenge has been managed in many countries by establishing special laws, it is still one of the controversial obstacles in the development of these treatments. New advances in solving challenges The good news is that the scientific community has made great strides in solving these challenges: - **Using iPSCs** cells (inducible pluripotent cells from the patient's own body) has greatly reduced the risk of transplant rejection and eliminated ethical issues. **Cell encapsulation technology** has made transplanting without the need for immunosuppressive drugs. In this method, beta cells are placed in biocompatible capsules that both protect the immune system and allow them to secrete insulin. - **Progress in the mass production of beta cells** has caused the costs to gradually decrease. Biotechnology companies and institutions are trying to make this technology affordable and accessible to all patients. Although the use of stem cells in the treatment of diabetes still faces challenges, the speed of scientific advances and new technologies promises that in the not too distant future, this method will become one of the main treatments for diabetes. The future of diabetes treatment with stem cells The use of stem cells in the treatment of diabetes has become one of the most exciting research topics in the medical world. With scientific advances in various fields such as genetic engineering and nanotechnology, the future of diabetes treatment with stem cells looks brighter than ever. These technologies, along with stem cells, can fundamentally transform the way diabetes is treated and move towards definitive and universal treatments. ### Outlook in the next decade: In the next decade, significant advances in the treatment of diabetes with stem cells are expected. Many research teams are currently in the early stages of clinical trials, and some treatments are gradually approaching the commercialization stage. In the next decade, these treatments will likely become a viable and cost-effective treatment option for diabetic patients. If this trend continues, in the next decade we may see the successful transplantation of stem cells in many hospitals and specialized clinics. These treatments can make a huge difference, especially for patients with type 1 diabetes who are dependent on insulin. Advances in the mass production of stem cells and reducing treatment costs are among the main goals for more access to these treatments. Also, it is expected that stem cell transplantation will be performed more widely in the future and with the lowest risk of transplant rejection. ### Hope for definitive and universal treatment The biggest hope in the treatment of diabetes with stem cells is to move towards definitive and universal treatment. Currently, diabetes treatment focuses more on disease management and blood sugar control. But with more advances in the field of stem cells, we can hope for a future in which diabetic patients no longer need continuous treatments and their body system naturally restores the function of the pancreas. These treatments can be implemented more widely, especially in countries with advanced health systems, and made available to patients in developing countries at lower prices. Advances in stem cell treatments can help reduce treatment costs and improve patients' quality of life. Finally, the definitive treatment of diabetes with stem cells can reach a stage where the disease is not only controlled, but completely cured. Although this vision is not yet within reach, the speed of scientific and technological advances suggests that this goal will not be far from reach. The future of diabetes treatment with stem cells is promising. Technologies such as genetic engineering and nanotechnology, along with stem cells, have the potential to fundamentally change the treatment of diabetes and move towards definitive, safe and accessible treatment. **To receive a visit (online or in person) with Dr. Yazdan Panah, fill out the form below**