Adipocytes: Fat cells

Antibody: Protein made by the B cells of the body’s immune system that is

specific to an antigen. It can bind to the antigen, allowing it to be recognised by the body as friend or foe.

Antigen: A molecule found either inside or on the surface of a cell that can

induce an immune response. Antigens are used by the body’s immune system to recognise whether the cell is a dangerous foreign intruder or a harmless part of the body. They are like molecular labels.
Anti-rejection drugs: The drugs that people who receive a transplant have to take to prevent their immune system from attacking the new cells.
Autoimmune: Conditions caused when the body’s immune system antibodies (the system that normally protects us from foreign germs like bacteria and viruses) start to attack some of the body’s own cells. Type 1 diabetes is one example of an autoimmune condition, which is caused when antibodies (the immune system’s chemical weapons) attack and destroy the insulin-producing islet cells.
Auto-immune conditions: These are caused when the body’s immune system (the system that normally protects us from foreign germs like bacteria and viruses) starts to attack some of the body’s own cells. Type 1 diabetes is one example of an auto-immune condition, which is caused when antibodies (the immune system’s chemical weapons) attack and destroy the insulinproducing
islet cells.

Autonomic neuropathy: A complication of diabetes that results from damage to the nerves that function automatically such as those that control the bladder and digestion. B cells: Specialised cells of the immune system which help to fight infections by making antibodies.They are also called B lymphocytes. In Type 1 diabetes, they help the T cells to kill the beta cells by making antibodies targeted specifically at the beta cells – these are called autoantibodies.
Beta cells: Beta cells are the individual cells that produce insulin. Beta cells are stored within the islets of Langerhans in the pancreas.
Beta cells (b cells): Specialised cells found in the Islets of Langerhans in the pancreas. Their job is to produce insulin. They are destroyed by the immune system in Type 1 diabetes.

Blood glucose levels: The amount of glucose being carried in the blood.
Cells: The body is made up of many tiny biological units or cells – they are the building blocks of the body. They all carry out special jobs such as making insulin (beta cells), carrying oxygen (red blood cells) or transmitting messages (nerve cells).

Chromosomes:We each have 23 pairs of chromosomes that contain all of our genetic information (DNA). Cytokines – Molecules produced by cells of the immune system to help them to communicate with each other. They help to orchestrate the activities of the immune system.

Complications: Complications are problems that arise as a result of a medical condition. In the case of diabetes, complications include eye disease (retinopathy), kidney disease (nephropathy), nerve damage (neuropathy), coronary heart disease and stroke.

COBE: A special piece of equipment which helps separate out islets from donor pancreases.
Cryopreservation: A process for preserving tissue for transplantation. Tissues are stored at a low temperature to prevent damage being caused by bacteria or chemical changes.

Glomerulus: The main filtration unit of the kidney. Each kidney is made up of thousands of these tiny tubes through which the blood passes. Water and soluble waste are filtered out as urine.
Glucose: A type of sugar.

Glycogen: The storage form of glucose.

HbA1c or glycosilated haemoglobin: This blood test measures your long term blood glucose control over the previous 8-12 weeks.Your diabetes team will advise you on the level which is best for you. For most people this will be 7% or lower.

Hyperglycaemia: Hyperglycaemia occurs when the body is unable to process glucose effectively, leading to raised levels of glucose in their blood. If somebody has diabetes, the glucose in their body is not turned into energy, either because there is not enough insulin in their body, or because the insulin that the body produces is not working properly. People with diabetes need to control their blood glucose levels either by diet alone, a combination of diet and tablets or with diet and insulin injections. Left uncontrolled, high blood glucose levels can lead to a dangerous condition called diabetic ketoacidosis, and also greatly increases the chances of developing complications such as eye disease or coronary heart disease.
Hypoglycaemia: Hypoglycaemia (or ‘hypo’) is the medical term for when the level of glucose in the blood falls too low, usually under 4 mmol/l. Treatment is very simple and requires taking some fast acting carbohydrate, such as a sugary drink, followed by a starchy snack such as a sandwich. Left untreated, hypoglycemia will eventually result in the person becoming unconscious.

Hypo unawareness: For some people the warning signs that usually accompany hypoglycemia may be lost.This may be as a result of keeping very tight control of blood glucose levels, and research has shown that as people experience hypos more frequently they begin to lose their ability to recognise the symptoms. Although rigorously avoiding hypos can be very effective in reversing problems of hypo unawareness, for some people whose blood glucose is prone to dramatic fluctuations, the problem can prove more
intractable. Hypo unawareness was one of the selection criteria used by the team in Edmonton when choosing participants for the islet transplantation research trial.
Hypo warning signals: When the level of glucose in a person’s blood falls too low the person often experiences ‘warning signs’, which occur as the body tries to raise the blood glucose level.These warning signs vary from person to person, but often include feeling shaky, sweating, tingling in the lips, going pale, heart pounding, confusion and irritability.

IDDM: Insulin dependent diabetes mellitus. Now more commonly known as Type 1 diabetes. The majority of beta cells in the pancreas have been destroyed by the immune system and the person needs regular insulin injections to survive.

Immunosuppression: The suppression of the body’s defence system against foreign bodies (the immune system), which is necessary in transplantation procedures to protect the transplant from being rejected. This is achieved using drugs.
Incubator: A piece of equipment that can be used to contain tissues or organisms in a controlled environment. Incubators can be used in experiments to help grow new islets.
Insulin: A hormone produced by the beta cells in the pancreas. It helps the body to control blood glucose levels and to control energy production.
Islets: Islet cells are the cells inside the Islets of Langerhans, part of the pancreas. There are three types of islet cells: alpha cells, which produce gut enzymes; delta cells, which act as a support structure for the islet cells; and beta cells, which produce insulin. All of the different types of islet cells are used in islet transplantation. Islets of Langerhans: The Islets of Langerhans are the ribbon-shaped structures within the pancreas which house the insulin-producing beta cells. Isolation: The process by which islets are separated from the other cell types within the pancreas. In the Edmonton protocol, special enzymes were used to digest the unusable pancreas tissue. A further stage of purification is also required.
Liver: The liver is a large organ located in the abdomen, which processes nutrients for use in the rest of the body. Lymphocyte: Small white blood cells that form a critical part of our immune system. There are several different types of lymphocyte including B cells (see B cells) and T cells (see T cells).
Metabolism: The process by which we convert the food we eat into the energy that cells in the body need to live.
Mitochondria: The powerhouses of the cell that convert glucose (sugar) into energy.
Monogenic: Single gene.‘Monogenic’ conditions are caused by a defect in a single gene, e.g. cystic fibrosis.

Nephropathy: A complication of diabetes that results from damage to the blood vessels in the kidney.
Neuropathy: A complication of diabetes that results from damage to the nerves.

NIDDM: Non insulin dependent diabetes mellitus. Now more commonly known as Type 2 diabetes. It usually results from reduced insulin secretion together with insulin resistance. It is usually managed by diet alone, diet and tablets, or diet and insulin injections.
Pancreas: The elongated organ situated just below the liver, which contains the islets of Langerhans. These in turn house the various islet cells, which include the insulin-producing beta cells.
Peristalsis: A series of normal coordinated muscle contractions that occurs automatically, for example to move food through the digestive tract.
Polygenic: Several genes. ‘Polygenic’ conditions are caused by a number of
genes.
Portal vein: A large vein that carries blood rich in digested nutrients from the stomach, spleen and oesophagus, and into the liver.

Purification: The process for preparing islets ready for transplantation. If islets are not carefully purified other potentially harmful material stored within the pancreas might be transplanted with them.
Rapumane: Another name for sirolimus, one of the drugs used to prevent the body from rejecting the islet transplants.
Receptor: A specialised molecule on the surface or within a cell that recognises and binds other specific molecules or proteins, triggering a response in the cell.
Retinopathy: A complication of diabetes that results from damage to the blood vessels in the back of the eye. It can lead to blindness.

Sirolimus: Another name for Rapumane, one of the drugs used to prevent the body from rejecting the islet transplants.

T cells: These are cells that play a key role in the body’s mechanisms for defending itself against foreign bodies (such as bacteria or viruses). Type 1 diabetes is caused by squads of T cells attacking the beta cells in the pancreas, for reasons we do not fully understand.
Transplantee: The person who receives a transplant.
Transplantation: The process by which damaged cells are replaced with healthy cells from another person.
Type 1 diabetes: Type 1 diabetes (also known as insulin dependent diabetes) develops when there is a severe lack of insulin in the body because most or all of the cells in the pancreas that produce it have been destroyed. It usually appears in people under the age of 40, often in childhood, and is treated by insulin injections and a healthy balanced diet.
Type 2 diabetes: Type 2 diabetes develops when the body can still produce some insulin, though not enough for its needs, or when the insulin that the body does produce does not work properly. This type of diabetes usually appears in people over the age of 40 and is treated by diet alone, by a combination of diet and tablets or by a combination of diet and insulin injection.