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Can the pancreas be repaired so it can start producing insulin?

Sunday, 07 December 2003
Answered by: Anju Virmani
Consultant Endocrinologist,
Sunder Lal Jain Hospital
New Delhi
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Q. I want to know how can improper working of pancreas be rectified and is it possible to rejuvinate it so that it can start producing required amount of insulin needed to consume blood sugar?

A.  The short answer to your question is No! The more detailed answer is: 1. Several drugs, primarily the sulphonylureas, stimulate the pancreas to increase production of insulin. They have been used in the treatment of type 2 diabetes for several decades. However, they work only till the pancreas is capable of being stimulated. Once the beta cells (which make insulin) are exhausted, these drugs do not work. 2. The other major strategy in treating or preventing diabetes is making the insulin produced by the body (naturally and/or in response to drugs) and/or taken by injection work more efficiently. This is done by: a. regular exercise and meal planning. b. In addition, drugs like metformin and the glitazones also help the insulin to work better. However, these drugs are useless if insulin is not being made by the body, as in type 1 diabetes. They work best in obese persons. 3. I suspect what you are more interested is the situation in type 1 diabetes (where the beta cells are destroyed) or long standing type 2 diabetes, in which the drugs begin failing. At present there is no scientifically proven method to make dead beta cells come back to life or transplant beta cells alone. So a situation where insulin production is insufficient has to be tackled by giving insulin injections. Pancreatic transplants are being done in many centers, but they need a cadaver organ donation program to be in place.

A.  The short answer to your question is No! The more detailed answer is: 1. Several drugs, primarily the sulphonylureas, stimulate the pancreas to increase production of insulin. They have been used in the treatment of type 2 diabetes for several decades. However, they work only till the pancreas is capable of being stimulated. Once the beta cells (which make insulin) are exhausted, these drugs do not work. 2. The other major strategy in treating or preventing diabetes is making the insulin produced by the body (naturally and/or in response to drugs) and/or taken by injection work more efficiently. This is done by: a. regular exercise and meal planning. b. In addition, drugs like metformin and the glitazones also help the insulin to work better. However, these drugs are useless if insulin is not being made by the body, as in type 1 diabetes. They work best in obese persons. 3. I suspect what you are more interested is the situation in type 1 diabetes (where the beta cells are destroyed) or long standing type 2 diabetes, in which the drugs begin failing. At present there is no scientifically proven method to make dead beta cells come back to life or transplant beta cells alone. So a situation where insulin production is insufficient has to be tackled by giving insulin injections. Pancreatic transplants are being done in many centers, but they need a cadaver organ donation program to be in place.

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