A single transplantation of the islets can produce glycemic stability and reduction of basal insulin requirement

Diabetes Res Clin Pract. 2006 Sep;73(3):235-40. doi: 10.1016/j.diabres.2006.01.012. Epub 2006 Apr 5.

Abstract

We investigated glycemic stability and insulin requirement 1 month after a single transplantation of the islets from non-heart-beating donors or a living donor. Overall blood glucose levels decreased immediately after transplantation. The M-value and mean amplitude of glycemic excursions (MAGE) decreased significantly from 53.0 (range, 8.9-91.0) to 4.2 (0.6-8.8, P<0.05) and from 8.5 mM (4.8-11.7) to 3.3 mM (2.0-4.5, P<0.05), respectively. The values after transplantation were lower than the first quartile of 102 type 2 diabetic control patients. The estimated HbA1c level decreased significantly from 7.9% (5.7-10.9) to 5.4% (4.7-5.9, P<0.05). The supplement of basal insulin decreased 43% from 0.31 units/kg/day (0.16-0.37) to 0.18 units/kg/day (0-0.22, P<0.05), while that of stimulated insulin did not decrease significantly, from 0.28 units/kg/day (0.13-0.51) to 0.21 units/kg/day (0-0.41). Thus, only one islet transplantation can be sufficient to attain metabolic stability, probably by effective supply of basal insulin secretion, sufficient to avoid life-threatening severe hypoglycemia and prevent or delay the progress of secondary complications of diabetes by decreasing the HbA1c level.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / metabolism*
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / therapy*
  • Diabetes Mellitus, Type 2 / blood
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Insulin / administration & dosage
  • Insulin / analogs & derivatives*
  • Insulin / blood
  • Insulin, Long-Acting
  • Islets of Langerhans Transplantation*
  • Male
  • Middle Aged
  • Time Factors

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Insulin
  • Insulin, Long-Acting