ONE O'CLOCK ON A SUNNY AFTERNOON, LOUIS DYKES AWOKE IN HIS CAR AT A GAS
STATION PARKING LOT 50 MILES NORTH OF CHATTANOOGA. He remembered leaving
his North Georgia home early that morning, but he had lost almost five hours.
“It’s unnerving not to know where you were or what you did,”
says the athletic 49-year-old. He had developed a condition called hypoglycemic
unawareness—meaning he no longer experienced trembling or other warning
signs when his blood sugar began sinking to dangerously low levels.
A healthy person has 3 million islet cells churning out insulin in the pancreas. As a teenager, Dykes suddenly, mysteriously, had none. As a type 1 diabetic, he depended on multiple daily injections, then an insulin pump, to provide the insulin his own body no longer produced. The second whammy, the terrifying onset of hypoglycemic unawareness, eventually proved a blessing, he says. It made him eligible for a new treatment at Emory, one of only a few places in the world performing transplants of islet cells harvested from the pancreases of donors. The first type 1 diabetic treated in the clinical trial at Emory had thrown away her insulin pump after one infusion of islet cells, her lifelong diabetes gone. But she was petite. At 165 pounds, the tall, lanky Dykes required three infusions, from three separate donors, before his transplanted islet cells could produce enough insulin to achieve the same miracle.
Dykes now must take daily toxic immunosuppressive drugs to prevent rejection of his islet cells. Filled with energy, once again in control of his body and mind, Lewis says taking the drugs is a trade-off he is delighted to make. But Christian Larsen, director of the Emory Transplant Center, and colleague Thomas Pearson, director of the kidney transplant service, are not satisfied with just one kind of miracle. Their research focuses on how to trick the body into accepting foreign tissue without having to suppress the entire immune system. Promising results—first in primates and more recently in human kidney transplant recipients—are evidence that these new strategies may one day pay off.
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