Thread by @1derfultype

The last mile for #T1D cure:
'I believe that cell therapy can be the T1D cure. We've had landmark results in the last 2y.
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs
#diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 1/n

The last mile for #T1D cure:
'We know now that #BetaCell replacement can cure T1D. This is the #BG profile of someone who used to live with #diabetes 1y 1/2 ago.'
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 2/n

The last mile for #T1D cure:
'We started #BetaCell in Milan replacement in 1989. Had to wait for 30y for this procedure to be recognised.'
-L. Piemonti

Can you imagine living without the mental load & physical burden of #diabetes?

#ISPAD2022 #dedoc° @dedocORG @ispad_org 3/n

The last mile for #T1D cure:
'Islet transplantation can be a clinical standard of #diabetes care in very specific conditions.'
-L. Piemonti

See conditions below ⤵️

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 4/n

The last mile for #T1D cure:

'Today, we have innovation:
▶️ 3D bioprinting
▶️ Encapsulation
▶️ Decellularisation
▶️ Gene editing

& alternative sources:
▶️ Pig islets
▶️ Stem cells
▶️ Blastocyst'
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices @dedocORG @ispad_org 5/n

The last mile for #T1D cure:
'But islet transplantation can't be THE cure as there are limits:
❌Not enough donors
❌Must use immunosuppression.'
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 6/n

The last mile for #T1D cure:
'But labs can now replicate pancreatic islets that are able to synthesise #insulin and #glucagon. They do reproduce the structure of the islets.'
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices
#payitforward @dedocORG @ispad_org 7/n

The last mile for #T1D cure:
'It is now possible to efficiently replace #BetaCells.
We also have knowledge on tissue remodeling, immune reaction and immunosuppression.'
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 8/n

The last mile for #T1D cure:
ESC derived pancreatic progenitors 1y clinical results:
✅ Well tolerated
✅ Mature #BetaCells
✅ #Cpeptide meal release
✅⬇️ #insulin needs
✅ #A1c <7%
✅⬆️ hypo awareness

#ISPAD #ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org 9/n

The last mile for #T1D cure:
'Gene editing [#CRISPR editing] will allow the islet replacement to be invisible to the immune system. the 1st clinical trial was approved in Canada in Nov21 & the 1st #PwD dosed in Feb22.'
-L. Piemonti

#ISPAD2022 #dedoc° @dedocORG @ispad_org 10/n

The last mile for #T1D cure:
'Brian Shelton is the 1st #PwD to have received human stem cell therapy. He is the 1st person living with #T1D. He reduced his insulin needs from 34 to 2.9u/day to insulin INdependence, a 99.9% #TIR & 5.2% #A1c.'
-L. Piemonti

#ISPAD2022 #dedoc° 11/n

The last mile for #T1D cure:
One major limit is that the cost of cell therapy is huge: 500 000 to 1 000 000€ for each #PwD.
6 of the ATMPs approved in Europe have already withdrawn their treatments because of the cost.

#ISPAD #ISPAD2022 #dedoc°voices @dedocORG @ispad_org 12/n

The last mile for #T1D cure:
'The #insulin free world is possible.
We need an alliance for an insulin free world - otherwise, we will fail.'
-L. piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs
#diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org