Clinical Efficacy of Stem Cell Therapy for Diabetes Mellitus: A Meta-Analysis

Abstract

BackgroundStem cell therapy is a promising therapeutic modality for advanced diabetes mellitus (DM). This study presents a meta-analysis of relevant clinical trials to determine the efficacy of stem cell therapy in DM. We aim to critically evaluate and synthesize clinical evidence on the safety and efficiency of different types of stem cell therapy for both T1DM and T2DM.Methods and FindingsWe pooled participant-level data from twenty-two eligible clinical trials that satisfied our inclusion criteria, with a total of 524 patients. There were significant differences in the outcome based on the type and source of the infused cells. Out of all T1DM patients who received CD34+ hematopoietic stem cell (HSC) infusion, 58.9% became insulin independent for a mean period of 16 months, whereas the results were uniformly negative in patients who received umbilical cord blood (UCB). Infusion of umbilical cord mesenchymal stem cells (UC-MSCs) provided significantly beneficial outcome in T1DM, when compared to bone-marrow mesenchymal stem cells (BM-MSCs) (P<0.0001 and P = 0.1557). Administration of stem cell therapy early after DM diagnosis was more effective than intervention at later stages (relative risk = 2.0, P = 0.0008). Adverse effects were observed in only 21.72% of both T1DM and T2DM stem cell recipients with no reported mortality. Out of all poor responders, 79.5% were diagnosed with diabetic ketoacidosis.ConclusionsStem cell transplantation can represent a safe and effective treatment for selected patients with DM. In this cohort of trials, the best therapeutic outcome was achieved with CD34+ HSC therapy for T1DM, while the poorest outcome was observed with HUCB for T1DM. Diabetic ketoacidosis impedes therapeutic efficacy.

Expanded autologous adipose derived stem cell transplantation for type 2 diabetes mellitus

“…For type 1 diabetes mellitus (T1D), both hematopoietic stem cell (HSC) transplantation and mesenchymal stem cell (MSC) transplantation have been evaluated (Cantu-Rodriguez et al, 2016;Cheng et al, 2016;El-Badawy and El-Badri, 2016;Snarski et al, 2016;Xiang et al, 2016;Xv et al, 2016). These studies have shown that HSC and MSC transplantations improve blood glucose levels from moderate to high.…”

“…These studies have shown that HSC and MSC transplantations improve blood glucose levels from moderate to high. The meta-analysis study carried out by El-Badawy and El-Badri (2016) showed that the best therapeutic outcome could be achieved with CD34+ HSC transplantation, while the poorest outcome was observed with umbilical cord blood transplantation (El-Badawy and El-Badri, 2016).…”

The potential of mesenchymal stem cells in diabetes mellitus

“…A recent meta-analysis study compared several clinical trials utilizing various stem cells for the treatment of diabetes mellitus. 24 Although this meta-analysis showed that therapy with CD34 + hematopoietic stem cells showed a superior outcomes, this study has several serious limitations, such as including only a small number of trials, which in turn include only a low number of patients, and the follow-up period was not sufficiently long in order to build any significant conclusion. Finally, although the results of the currently available clinical trials involving MSCs in treating diabetes are encouraging, it is necessary to have larger, randomized, and double-blinded studies, with a longer duration of follow-up, in order to validate the findings obtained.…”

Cure of Insulin-Dependent Diabetes Mellitus by an Autologous Hematopoietic Stem Cell Transplantation Performed to Control Multiple Myeloma in a Patient with Chronic Renal Failure on Regular Hemodialysis

“…DM affects millions of people worldwide and is associated with serious complications that affect all body organs [78][79][80]. The available therapeutic modalities for DM include: diet and lifestyle modifications, oral hypoglycemic agents, insulin injections and islet cell transplantation [79,81,82].…”