Nina Greene’s diabetes was so hard to control, she had “Type 1 Diabetic” tattooed on her left wrist—a guarantee that emergency medical personnel could identify her illness quickly if she was found unconscious. Despite all her efforts to manage her diabetes, she wound up in hospital so often with high or low blood sugars that, at times, she wasn’t sure she could carry on.
Technically, Greene still has diabetes, but she hasn’t had to take insulin since September 2019, after she received a transplant of islet cells, which produce insulin. Today, she is living a life she could only dream of before the transplant. Every morning when she wakes up, she feels optimistic.
“If I keep exercising and not eating too much sugar, I can live a natural life,” she said from her home in Fort McMurray, Alta.
Greene, now 53, received her new islets in January 2017 as part of the Edmonton Protocol transplant program, which was developed by researchers at the University of Alberta and has become the world standard for such procedures.
“It just wasn’t working for me”
Greene, who identifies as Indigenous on her mother’s side, was first diagnosed with diabetes in her early 30s. The disease runs in her family, and affects Indigenous people in Canada at a rate three to five times higher than the general population. Greene’s grandmother had Type 2 diabetes. So does her grown daughter. And Greene’s younger brother was diagnosed with Type 1 diabetes two years before she was.
Before the transplant, her illness was extremely hard to manage. She went from taking pills to being on daily shots of insulin. She even tried an insulin pump, which provides a continuous infusion of insulin. But the dose was never right and she rode a rollercoaster of dangerously high and low blood sugars.
“All the measures I took—watching what to eat, counting my carbohydrates, scaling and comparing my dose with the insulin I was supposed to take—it would still be too much, then it wasn’t enough, so my sugars would shoot up,” Greene said.
“It just wasn’t working for me.”
Numerous trips to emergency meant Greene had to quit her job at a camera store. Her husband, Brent, who works for Suncor as a mining equipment scheduler, was afraid to leave her alone.
“The rollercoaster became normalized, which is crazy,” he said. “I’d call home at my first coffee break and when she answered I’d say, ‘Thank God, you’re up.’
“It was very emotional and scary for me and it was hard to watch her feel so down,” he said. “Sometimes the ER doctors would tell us, ‘We don’t know if she’s going to make it.’ ”
Research goal: more success stories
Greene was patient number 252 for the U of A transplant team, which just marked its 300th islet transplant surgery performed in Edmonton.
Type 1 diabetes is an autoimmune disorder that attacks the insulin-producing cells, called islets, which are located in the pancreas. By injecting donor islet cells into the liver, they are protected from attack by the immune system, so patients can live insulin-free for at least a period of time.
The hunt continues for new sources of islets, because there just aren’t enough donors to keep up with demand. U of A researchers are now working on a “cure” by reprogramming a patient’s own blood to start producing insulin again—what could be the ultimate step in the life-saving diabetes work that has been happening at the university ever since insulin was discovered 100 years ago with the help of U of A biochemist James Collip.
The goal is to make Greene’s success story available to many more of the estimated 400,000 people who live with Type 1 diabetes around the world.
“Keep your phone on at all times”
One of Greene’s doctors told her the fact that her diabetes was so difficult to manage would make her the perfect candidate for a transplant. She was referred to Peter Senior, an endocrinologist at the U of A, who connected her with transplant surgeon James Shapiro. Both are members of the Alberta Diabetes Institute. They assessed Greene in May 2016 and put her on the waitlist.
Keep your phone on at all times, they told her, in case a donor with matching islets was located.
After several months, the habit slipped and Greene didn’t have her phone at hand. The RCMP came to her door late one night in January 2017 to let her know a donor had been found.
“It was sad, because finding a donor means somebody has to go away for you to get your islets, but it was also very exciting,” Greene said.
The pair packed their bags and drove through the night to Edmonton. Greene had the transplant the next morning. After so much anticipation, the procedure itself was underwhelming.
“You’re awake, but sedated,” she said. “They just use a long needle and slowly inject the islets into your liver. No big cuts, nothing. It was the easiest operation I’ve ever had in my life.”
“A second chance at a better life”
Greene’s blood sugars stabilized immediately, and she was sent home from hospital after just eight days. At first, she had to take 15 to 20 pills a day to ensure the donor cells would not be rejected by her body. She also had to keep taking a small dose of insulin to ensure the new islets didn’t get too stressed, but that was finally discontinued in September 2019.
“My sugars have been perfect. It still amazes me,” she said. “I’ve been blessed with a second chance at a better life.”
Greene can now play with her grandkids without having a sugar low or getting tired. She goes for daily walks with Brent and loves to knit and sew. She still watches what she eats.
“Just because I have islets now doesn’t mean I can eat a whole cake, but I can have a piece of cake without any trouble.”
Greene takes anti-rejection medication twice a day, with no side-effects. Her tattoo reminds her of how far she’s come. “It’s a fantastic feeling to take a few pills and know I’m done for the day. I’m no longer constantly poking my fingers, injecting insulin or popping sugar pills [to treat low blood sugar].”
“I’m so proud of Dr. Shapiro and the support team for doing such a fantastic job at this!”
This month, the University of Alberta celebrates 100 years since Canadian scientists, including U of A biochemist James Collip, discovered and purified insulin, making it possible to live with diabetes. Since then, research breakthroughs at the U of A have continued to make life better for people living with diabetes and their families. Today, with support from partner organizations and donors such as the Allard Foundation , DRIFCan and the Alberta Diabetes Foundation , we are closer than ever to a cure. Read more about diabetes research .