TABLE 1

Pros and cons of beta-cell therapies

ProsCons
Pancreas transplantAppropriate alternative to insulin for patients getting kidney transplant, failure of injectable insulin, or patients suffering from uncontrollable hyper- or hypoglycemia
Increased rate of death in the first 90 days after surgery
Lifetime immunosuppression required
Islet cell transplantLess invasive than pancreas transplant
Less intensive immunosuppression needed than with pancreas transplant
Improvements are needed in harvesting islet cells and increasing survival of transplanted donor cells
Need 2 to 4 donors per recipient
Lifetime immunosuppression required
Bionic pancreasNo immunosuppression needed
Electronic adjustment of insulin and glucagon prior to hypoglycemia without patient initiation
Reduces hypoglycemia, stabilizes glucose levels
High cost of supplies and technology
Not a biologic cure
Needs human involvement to maintain