Advances in Stem Cell Therapy for Type 2 Diabetes Mellitus

Elie Bertran¹, Rami Saleh², Grace Weber³, Tarek Weber⁴

1. University of Balamand Faculty of Medicine, Lebanon. Notre Dame University Hospital, Lebanon.
2. University of Balamand Faculty of Medicine, Lebanon. Notre Dame University Hospital, Lebanon.
3. Sabis International Educational System
4. University of Balamand Faculty of Medicine, Lebanon. Notre Dame University Hospital, Lebanon.

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PUBLISHED: 31 December 2024

CITATION: BTERRANI, Elie et al. Advances in Stem Cell Therapy for Type 2 Diabetes Mellitus. Medical Research Archives.  Available at: <https://esmed.org/MRA/mra/article/view/6174>. 

COPYRIGHT: © 2025 European Society of Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

DOI: https://doi.org/10.18103/mra.v12i12.6174.

ISSN 2375-1924

1.Introduction

The global prevalence of T2DM is on the rise, affecting over 463 million people worldwide. The major damage of chronic hyperglycemia is its association with long-term complications to various organs including retinopathy, nephropathy, and neuropathy, as well as cardiovascular disease with underlying micro and macrovascular destructions. The pathobiology of T2DM involves primarily insulin resistance and ultimately loss of islet β-cell insulin production.

Despite advancements in pharmacological treatments, a significant proportion of patients do not achieve adequate glycemic control, and many develop complications leading to increased morbidity and mortality. The mesenchymal stem cells (MSCs), being effective in a number of these pathologies, have emerged as a promising therapeutic option.

2. Stem cell therapy overview

Stem cell therapy has gained attention for its therapeutic efficacy and safety profile. Hematopoietic stem cells (HSCs), while traditionally associated with blood formation, have shown potential in regenerative medicine for their ability to differentiate into various blood cell types and support tissue repair. In the context of T2DM, HSCs can contribute to the restoration of normal immune function, thereby addressing inflammation that exacerbates insulin resistance. Additionally, HSCs can influence the microenvironment of pancreatic islets, potentially improving β-cell function and survival. Research indicates that HSC transplantation may lead to better metabolic control and a decrease in diabetes-related complications. However, the mechanisms through which HSCs exert their beneficial effects in T2DM require further investigation.

3.Types of stem cells used in therapy

MESENCHYMAL STEM CELLS (MSCS): MSCs have garnered attention for their regenerative properties and ability to modulate immune responses. They can differentiate into various cell types, including adipocytes, chondrocytes, and osteoblasts, and secrete growth factors that facilitate tissue repair. In T2DM, MSCs can enhance insulin sensitivity and support the regeneration of pancreatic B-cells, thereby improving insulin secretion. In addition to their regenerative potential those cells have multiple effects on different arms of the immune system. Studies have demonstrated that MSCs can reduce systemic inflammation and promote vascular health, which are critical in managing diabetes-related complications. The source of MSCs, whether from bone marrow, adipose tissue, or umbilical cord, may influence their therapeutic efficacy and safety profile, making them a versatile option for clinical applications16-20 HEMATOPOIETIC STEM CELLS (HSCS): HSCs, while traditionally associated with blood formation, have shown potential in regenerative medicine for their ability to differentiate into various blood cell types and support tissue repair. In the context of T2DM, HSCs can contribute to the restoration of normal immune function, thereby addressing inflammation that exacerbates insulin resistance. Additionally, HSCs can influence the microenvironment of pancreatic islets, potentially improving B-cell function and survival. Research indicates that HSC.

Table 1: Recently published studies on stem cell use

transplantation may lead to better metabolic control and a decrease in diabetes-related complications. However, the mechanisms through which HSCs exert their beneficial effects in T2DM require further investigations21-23

4.Recent clinical trials and comparative studies

Recent clinical trials have investigated the efficacy of MSCs and HSCs in managing T2DM, revealing promising outcomes. The following table provides a comparative overview of these studies:

Type of Stem Blood Glucose HbA1c Study Year Cells Sample Size Complications Reduction Change Assessed Wang et al. Retinopathy,2021MSCs 30 30% -1.5% Nephropathy Zhao et al. 2022 HSCs 50 25% -1.2% Cardiovascular events Combined Neuropathy, Lee et al. 2023 40 35% -1.8% MSCs/HSCs Cardiovascular events Nephropathy, Kim et al. 2020 MSCs 25 20%-1.0% Neuropathy MicrovascularPatel et al. 2023 MSCs 35 28%-1.5% complicationshese studies demonstrate the potential of stem cells to significantly improve glycemic control, as indicated by reductions in blood glucose and HbA1c levels. Notably, the combined use of MSCs and HSCs appears to offer enhanced benefits, addressing both glycemic control and complication management

5.Effects of stem cells on blood glucose and hba1c levels

Multiple studies have confirmed that MSC therapy leads to significant reductions in fasting blood glucose levels and HbA1c. For instance, Wang et al. reported a 30% reduction in blood glucose among patients receiving MSCs, alongside a notable decrease in HbA1c levels. This effect is attributed to improved insulin sensitivity and enhanced B-cell function, potentially driven by the

anti-inflammatory cytokines secreted by MSCs. HSCs have also demonstrated efficacy, albeit with varying results compared to MSCs. observed a 25% reduction in blood glucose, highlighting the potential of HSCs in managing T2DM. The effectiveness of these therapies may vary based on the source of stem cells and the method of administration. Additionally, the timing and frequency of treatment could play critical roles in achieving optimal outcomes29-31

6.Impact on micro and macrovascular complications

Stem cell therapy has shown promise in alleviating both microvascular and macrovascular complications associated with T2DM. MICROVASCULARCOMPLICATIONS:Studies have indicated that MSC treatment can lead to

7.Advances in stem cell therapy

Despite the promising results, several challenges persist in the application of stem cell therapy for T2DM. Issues related to the source of stem cells, optimal dosing, and timing of administration need to be addressed. Furthermore, the long-term effects and safety of stem cell therapies must be evaluated in clinical trials.

8.Challenges and future directions

Despite the promising results, several challenges remain for stem cell therapy for T2DM. Issues related to the sourcing of stem cells, ethical considerations, and the variability of patient responses pose significant hurdles. The cost of stem cell therapies and the need for specialized facilities can also limit accessibility for many patients. Future research should focus on standardizing protocols, understanding the long-term effects of stem cell therapies, and exploring the combination of these therapies with traditional pharmacological treatments. Additionally, larger-scale clinical trials are essential to validate the findings of smaller studies and to assess the safety and efficacy of stem cell therapies in diverse populations43.

9.Conclusion

In conclusion, stem cell therapy represents a novel approach to managing T2DM, with the potential to improve glycemic control and reduce the need for lifelong pharmacotherapy. As research advances, innovative applications of stem cell science combined with other modalities such as gene therapy and bioprinting to replace damaged tissue are being explored.

Conflict of Interest:

None.

Funding Statement:

None.

Acknowledgments:

None.

References

1. Classification and Diagnosis of Diabetes. Standards of Medical Care in Diabetes. 2021; 44(Suppl 1):S15-S35.
2. International Diabetes Federation. 2021. IDF Diabetes Atlas (9th ed.).
3. Wang et al. 2021. Stem Cells. 2021; 39(1):154-163.
4. Lee J, Cho J, D’Egidio F, Vignone C, et al. “Probing multiple transplant delivery routes of CD+ stem cells for promoting behavioral and histological benefits in experimental ischemic stroke.” Stem Cells Translational Medicine. 2021; 10(2):177-190.
5. Zhu Y, Ge J, Huang C, Liu J, Jiang H. “Application of stem cell therapy in diabetes.” Diabetes Care. 2021; 44(3):e45-e46.