FOR Rachel Brown, it has eliminated the paralysing fear she will collapse for a third time and stop breathing, when no-one is around to help.

The 35-year-old forensic scientist is among those with Type 1 Diabetes who are unable to tell if they have hypoglycaemia, when blood sugar levels drop to dangerously low levels.

It has led to her collapsing – luckily, when her partner was around – and being unable to do many of the things most of us take for granted, such as driving to work or going to the theatre.

Her life has been transformed by Islet transplantation. Pancreatic islets contain beta cells that make the hormone insulin, which helps control blood glucose levels.

HeraldScotland:

Now, changes in the way UK-wide transplants are carried out – as a result of research involving the University of Edinburgh –  could ensure patients have an even better outcome from the surgery.

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A study, involving Professor Shareen Forbes, Professor of Diabetic Medicine at the University of Edinburgh, found that reducing the time between the two donations had a better impact on transplant function.

Of the 84 participants who required two transplants to improve blood glucose control, a time interval of less than three months led to a 75% reduction in total daily insulin dose compared to 48% in those transplanted between three and six months or longer.

UK research has already shown islet transplantation prevents further severehypoglycaemia, even though the majority are not free from insulin injections. 

Prof Forbes said: “What the studies have shown is that if you get repeated readings of low glucose levels you lose the ability over time to tell when your blood sugar is going low.

“These are the people who fall asleep at the wheel. One transplant is mainly not adequate for glucose control.

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“The reason we don’t transplant everyone is that they have to go on to immunosuppressant medication, which have side-effects, expose the person to risk of infection and, more seriously, to the risk of cancer.

HeraldScotland:

“It’s accessible for the right people. 

"If we can in the future not give it with immunosuppression then that opens it up to many others.”

It is hoped the new opt-out transplant system will lead to more patients benefiting, as the study also found most patients require two islet transplants.

Ms Brown, who was diagnosed with Type 1 diabetes at the age of 11, had her second islet transplant on August 12.

She said: “It’s been amazing. As soon as my diabetes got out of control, I had to suspend my driver’s licence.

“For [going to] court and crime scenes I effectively ‘borrow’ people as taxis and use it as a training session.

“My awareness of my blood sugar levels has started to come back and I think all but one person [who has had the transplant]  has had their awareness come back and that’s phenomenal.

“I’ve had three ‘hypos’ that needed paramedics. All the symptoms are similar, your body is just trying to conserve sugar so it shuts off vital things in a priority list.

"Your brain shuts down, so usually you are unconscious. My body decided breathing wasn’t required so for the last two that I had I stopped breathing.

HeraldScotland:

“Luckily, by chance, my partner was here. He works away for 50 per cent of the year [as a Calmac employee].  

“I would say the biggest benefit is that my family has peace of mind. Day-to-day you don’t feel so much of a burden.”

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The study involved data sourced from the UK islet transplant consortium – this is made up of seven hospitals in Edinburgh, Newcastle, London (Kings and the Royal Free Hospital), Oxford, Manchester and Bristol. 

Dr Faye Riley, senior research communications officer at Diabetes UK, said: “For people living with Type 1 diabetes who have severe hypos because they don’t get or can’t recognise the warning signs of low blood sugar, islet transplants can be life-changing and life-saving.

“But because there are only a small number of donor pancreases available for islet transplantation each year, it’s crucial they are used in the best way possible.

"This research, supported by Diabetes UK, has changed the way islet transplants will be offered in the UK, by demonstrating the most effective way of using this treatment. . 

"We hope it will mean more people who receive a transplant can experience 
life-changing benefits and a better quality of life.”