A single transplantation of the islets can produce glycemic stability and reduction of basal insulin requirement.
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.
Sassa
Mariko
M
Department of Diabetes and Clinical Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Fukuda
Kazuhito
K
Fujimoto
Shimpei
S
Toyoda
Kentaro
K
Fujita
Yoshihito
Y
Matsumoto
Shinichi
S
Okitsu
Teru
T
Iwanaga
Yasuhiro
Y
Noguchi
Hirofumi
H
Nagata
Hideo
H
Yonekawa
Yukihide
Y
Ohara
Takeshi
T
Okamoto
Masahiko
M
Tanaka
Koichi
K
Seino
Yutaka
Y
Inagaki
Nobuya
N
Yamada
Yuichiro
Y
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood; D049528:Insulin, Long-Acting; D016381:Islets of Langerhans Transplantation; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D049528:Insulin, Long-Acting