type 1 diabetes

My daughter was recently diagnosed with type 1 diabetes and I have been doing a lot of research on this autoimmune disease. I have a bunch of medical questions that have probably been answered so I thought I would ask them a couple at a time.

If the theory is that there are bad immune cells that are attacking the pancreas than why are the people that are having a pancreas transplant becoming insulin injection free. It would only seem logical that the bad immune cells would still attack the new pancreas. What if the pancreas is secreting a foreign substance that the immune system doesn't like and it starts to attack the pancreas because of it.

Another question I have is that the pancreas releases many types of hormones to the body and one of them being somatostatin which inhibits the production of insulin, could this be the reason that my daughter is not secreting enough insulin.

[JDRF-Team-sgg]

You are correct in your question about pancreas transplants stilll being problematic in that the immune system still can atttack transplanted pancreas cells. Some people who have transplants DO find that the new pancreas is attacked and the insulin-producing cells are killed off after transplants. At this time, transplants do not always provide permanent cures, and people who have transplants must take anti-rejection drugs and immune-system suppressing drugs. Research is still being done on this immune system problem that seems to be the root cause of type 1 diabetes (sometimes called auto-immune diabetes). This is one reason that pancreas transplants are NOT considered currently to be an automatic cure for all patients with type 1 diabetes,  and transplants are still only being studied experimentally. This procedure is still not an option for people who are not suffering from complications that are life-threatening because of this problem, which can cause rejectionof the new pancreas.

You also asked about the production of Somatostatin. Your question basically is whether an OVER-production of this hormone could be inhibiting your daughter's secretion of insulin. Your question is about insulin RESISTANCE, which is the effect of too much of this hormone. This problem is the main cause of type 2 diabetes, which is not an auto-immune disease like type 1 diabetes. In type 1 diabetes, insulin-resistance is rarely a problem, but you could discuss this with your doctor and have him or her better explain why the tests that have been run on your daughter indicate type 1 instead of type 2 diabetes. Problems with somatostatin are rare among type 1 diabetics, and there would be no reason for your doctor to suspect that this is the cause of her elevated glucose levels. Blood tests can be done to detect elevated autoimmune activity and therefore the presence of type 1 diabetes rather than type 2 diabetes. It is fairly obvious to most doctors if insulin resistance is the problem, for if this is the case, some insulin is usually still being produced by the pancreas, but it is not effective. Your doctor's experience will show him or her whether insulin resistance is a factor simply by looking at how much insulin your daughter requires to lower glucose levels after eating carbohydrates. If the glucose levels do not respond to insulin injections in a normal manner, then the doctor may evaluate insulin resistance, but if normal amounts of insulin are bringing her glucose levels down in the normal time-frame, there would be no cause to suspect that production of somatostatin is an issue at all.