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Evidence to Improve Care

Pancreas Islet Transplantation for Patients With Type 1 Diabetes Mellitus

Ontario Health Technology Advisory Committee Recommendations

  • OHTAC recommends that pancreas islet cell transplantation be publicly funded as a treatment option for eligible adults with type 1 diabetes mellitus who have frequent episodes of hypoglycemic unawareness and/or uncontrollable diabetes despite optimal medical therapy.

Read the full OHTAC Recommendation

Type 1 diabetes is a chronic condition where the insulin-producing cells in the pancreas stop functioning. As a result, patients with type 1 diabetes require lifelong insulin therapy to control their blood sugar levels.

Despite treatment with insulin, a very small proportion of people with type 1 diabetes experience large, unpredictable changes in their blood sugar level. Some of these people aren’t aware when their blood sugar gets to dangerously low levels. This is known as hypoglycemic unawareness. Hypoglycemic unawareness can significantly affect quality of life and can potentially lead to brain damage or premature death.

Pancreatic islet transplantation is a type of cell replacement therapy in which islets (tiny clusters of cells) from the pancreases of deceased organ donors are purified, processed, and transplanted into another person. The goal of pancreatic islet transplantation is to improve blood sugar control, and in particular to reduce hypoglycemic unawareness. Some patients are even able to stop using insulin altogether.

Pancreas Islet Transplantation for Patients With Type 1 Diabetes Mellitus: A Clinical Evidence Review (PDF) 
September 2015

Patient Perspectives on Quality of Life With Uncontrolled Type 1 Diabetes Mellitus: A Systematic Review and Qualitative Meta-synthesis (PDF)
September 2015

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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry is currently funding the pancreas islet cell transplantation procedure as a treatment option for eligible adults with type 1 diabetes mellitus who meet appropriate clinical criteria.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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