Diane Knowles

Living a life without seizures seemed like an impossible dream for Diane Knowles, a legal secretary from Jacksonville, Fla. For 15 years, Diane battled frequent grand-mal seizures when her blood sugar level would nose-dive as a result of diabetes. One major seizure landed Diane in the emergency room with serious cuts and bruises. Another caused her to crash her car on a busy bridge.

Amazingly, though, Diane's dream of being seizure-free became reality when in 2002 she received a pancreas transplant at Mayo Clinic in Jacksonville. And, not only did the transplant eliminate the seizures, it cured her diabetes, as well.

A possible cure

For 23 years, Diane had lived with type 1 diabetes, a condition that develops when an individual's pancreas makes little or no insulin. Major fluctuations in her blood sugar levels due to extreme sensitivity to insulin triggered her seizures. The insulin sensitivity made it almost impossible to control her disease. Diane had resigned herself to living the rest of her life with seizures and other complications from her disease.

All that changed, however, when in April 2002, she met Robert Smallridge, M.D., an endocrinologist at Mayo Clinic, who gave her the news she never thought she would hear. Dr. Smallridge told Diane that a pancreas transplant could not only could stop her seizures, it also could eliminate the diabetes all together.

An uncommon scenario

Diane's case was unusual because a pancreas transplant alone is uncommon. Often, patients have to undergo a pancreas transplant in tandem with a kidney transplant, which usually becomes necessary because diabetes has damaged their kidneys. In 2001, according to the United Network for Organ Sharing, there were 13,490 kidney transplants, 912 kidney/pancreas transplants and only 436 pancreas transplants.

Dr. Thomas Gonwa, medical director of the kidney/pancreas transplant program at Mayo Clinic in Jacksonville, says a pancreas transplant is not standard treatment for diabetes because most people who have diabetes can effectively control their blood sugars with insulin. For those individuals who cannot control blood sugar despite intense treatment, a pancreas transplant can offer a cure. But, in order to be considered for a pancreas transplant, individuals with diabetes must have at least 50 to 60 percent kidney function.

"A transplant is not going to reverse any damage that's already occurred," Gonwa said, "But it hopefully will prevent new progression."

Because Diane's body was overly sensitive to insulin and her kidneys were still in good shape, she was a prime candidate for the procedure. "There was no doubt," says Diane about deciding to have the transplant. "Dr. Smallridge said there was only one way for me to go, and that was down."

A new world

Diane received a pancreas transplant on Aug. 7, 2002, after being on the waiting list for only three weeks. Now, she's seizure-free.

"I'm a different person," Diane says. "I don't feel like I have to have a babysitter anymore. It was to the point where my husband couldn't go to work at night unless I was with somebody. Either my mom or one of my kids had to stay with me."

According to Dr. Gonwa, Diane's prognosis is excellent. She now takes a few pills each day to keep her body from rejecting the new organ, but she's free from the regimen of daily insulin shots. Best of all, she can spend time with her grandchildren knowing that a seizure won't interfere.

"They've really done a miracle here," she says.