Insulin independence and normalization of oral glucose tolerance test after islet cell allotransplantation.
To achieve permanent normoglycemia in patients with type I diabetes, it is necessary to renew the insulin-producing beta-cells by transplantation of either a vascularized pancreatic graft or isolated islets of Langerhans. Presently, about 10% of patients with type I diabetes undergoing islet allotransplantation achieve insulin independence; however, glucose intolerance remains in the majority of cases. We report a case of long-term insulin independence after islet allotransplantation in a type I diabetic patient. Three years after islet transplantation, the patient remains insulin-independent with a normal oral glucose tolerance test (OGTT). The patient therefore no longer meets the World Health Organization criteria for the diagnosis of diabetes mellitus and demonstrates that islet transplantation can cure diabetes in type I diabetic patients.
Cretin
N
N
Division of Digestive Surgery, Department of Surgery, University Hospital, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. ncretin@tbrc.mgh.harvard.edu
Caulfield
A
A
Fournier
B
B
Bühler
L
L
Becker
C
C
Philippe
J
J
Morel
P
P
D000328:Adult; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005934:Glucagon; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D016381:Islets of Langerhans Transplantation / Q000502:physiology*; D012016:Reference Values; D013997:Time Factors; D014184:Transplantation, Homologous
D001786:Blood Glucose; D002096:C-Peptide; D007004:Hypoglycemic Agents; D007328:Insulin; D005934:Glucagon