People with type 1 diabetes live with lifestyle restrictions, blood glucose checks, insulin and other therapies, and always the possibility of hypoglycaemia. So how does life change for the relatively few people who’ve had the opportunity to receive an islet cell transplant?
Professor Jane Speight, foundation director of the Australian Centre for Behavioural Research in Diabetes (ACBRD), has gathered some insights through her work on the psychosocial issues associated with islet cell transplantation.
Prof Speight was an invited speaker at the 77th Scientific Sessions of the American Diabetes Association held this month in San Diego. The limbic spoke to Professor Speight on her return.
What are some of the common concerns that people with type 1 diabetes have when considering a islet cell transplant, and how can health professionals best assist during the decision making process?
People are concerned about how to balance the risks against the potential benefits. So the healthcare team needs to discuss the potential disadvantages with them clearly and openly. Once they decide to have the procedure, then it is a waiting game.
People told us they had to temper their enthusiasm (and particularly their family’s positive expectations), putting life on hold ‘just in case’ the telephone rings, and sometimes dealing with the ‘false alarm’ of being called in for the procedure but something going wrong at the last moment, such as the transplant team can’t isolate enough islet cells from the donor pancreas.
They also worry about the risks to their immune system and side effects of immunosuppression therapy – but mostly, people told us they took an optimistic or fatalistic view. One person said, “There are risks to everything. You walk across the road and it’s a risk, isn’t it?”.
Does your research indicate which people, from a psychosocial perspective, might be most suited to islet cell transplantation? Are there personality traits or life circumstances associated with a better outcome?
Our qualitative research reveals that those who feel most positive after receiving an islet transplant are those whose main concern pre-transplant was recurrent severe hypoglycaemia. It is the freedom from hypoglycaemia that drives the benefit people experience.