Islanders beg to try banned diabetes cure

By SIMON COLLINS science reporter

Cook Islanders desperate for a cure for their diabetes have volunteered to receive implants of insulin-producing pig cells which have been banned in New Zealand.

The full Cabinet of the tiny nation, whose 20,600 people have one of the world's highest rates of diabetes, will hear a presentation tomorrow from Dr Bob Elliott, the Auckland doctor who pioneered the cell implants.

Health Minister Annette King has asked Ministry of Health officials to contact the Cooks' ministers immediately to explain why New Zealand rejected Dr Elliott's request to conduct the procedure in New Zealand.

But the MP representing New Zealand Cook Islanders in the Cooks Parliament, Dr Joe Williams, said the islands were independent and Mrs King had no right to tell them what to do.

"That would be direct interference in the internal affairs of a country."

Dr Williams, a doctor in the Mt Wellington Accident and Family Health Centre, approached Dr Elliott several months ago on behalf of his diabetic patients.

He estimated that more than 20 per cent of the Cook Islanders over the age of 50 who attended his clinic suffered from diabetes.

"We are seeing them every day," he said. "It is reaching epidemic proportions."

One man who was in his clinic yesterday, 49-year-old Terepai Teiti, has gangrenous feet because he injured them on a beach and did not feel any pain because of his diabetes.

Two years ago, he had to have a toe amputated when he collapsed at home because of a low blood sugar level, injuring his toe in the fall.

"I would volunteer to find a cure for this terrible disease," he said.

Dr Elliott's company, Diatranz, implanted insulin-producing pig cells in six "Type 1" diabetics, who have to inject themselves with insulin several times a day, in New Zealand in 1996.

But its applications to carry out further trials since then have been turned down, forcing the company to conduct its latest trials inMexico.

One teenage girl in that trial has gone off insulin injections because the pig cells in her body have taken over normal insulin production.

Dr Elliott said the proposed trial with 24 people in the Cooks would be the first involving "Type 2" diabetics.

They usually develop diabetes later in life and can control it with pills, diet, exercise and, if necessary, a single injection of long-acting insulin at bedtime.

About 90 per cent of New Zealand's 115,000 diabetics are Type 2.

"The pills start to run out of steam as the disease progresses," Dr Elliott said.

He said he had not yet agreed to do the trial in the Cooks, and would need to be satisfied the facilities were adequate.

"This is a trial and the conditions are pretty arduous," he said.

"It requires frequent blood testing to see what the effects of the cells are.

"We are not going to drop the standards of the trial that were used to do the trial in Mexico."

Dr Elliott expects that if the trial goes ahead, it will be within the next six months.

He said that New Zealand patients would not be eligible"at the moment".

"We'll do this and see what happens.

"But if we are not getting progress here, the next step beyond that - well, who's to say?"

He said he was "99.999 per cent certain" that any retroviruses (viruses that can be transmitted to other individuals in body fluids) in the pig cells could not be transmitted to humans because they would be rejected by the human immune system.

But the Ministry of Health's chief adviser on safety and regulation, Dr Bob Boyd, said other authorities disputed this opinion.

He said the United States Food and Drug Administration permitted pig-cell implants only in people beyond childbearing age, and the patients were being very closely studied.

"One of the international guidelines is quite clearly that work of this type should be done only in countries where there is a regulatory framework where there would be monitoring of patients, records kept and regulatory oversight.

"That didn't occur in Mexico. Mexico is known as a place where people can go and do any sort of trial without any regulatory control."

He had never heard of any clinical trial that had been conducted in the Cook Islands.

Ministry figures show that 4 to 8 per cent of Pacific people in New Zealand suffer from diabetes, compared with 2 to 5 per cent of the general population.

The figures are approximate because many people with diabetes do not realise they have it.

Diabetes in NZ

Diabetes is caused by the pancreas failing to produce enough insulin, a chemical crucial for the body to absorb sugar for energy.

Type 1 diabetics must inject insulin several times a day to regulate their blood sugar level.

Type 2 diabetes - NZ's most common type - usually develops later in life and can be controlled with pills, exercise and insulin at bedtime.

nzherald.co.nz/health