title: A single transplantation of the islets can produce glycemic stability and reduction of basal insulin requirement.
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.
authors.affiliation: Department of Diabetes and Clinical Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Sassa
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Fukuda
authors.forename: Shimpei
authors.initials: S
authors.lastname: Fujimoto
authors.forename: Kentaro
authors.initials: K
authors.lastname: Toyoda
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Fujita
authors.forename: Shinichi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Teru
authors.initials: T
authors.lastname: Okitsu
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Iwanaga
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Noguchi
authors.forename: Hideo
authors.initials: H
authors.lastname: Nagata
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Yonekawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ohara
authors.forename: Masahiko
authors.initials: M
authors.lastname: Okamoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Seino
authors.forename: Nobuya
authors.initials: N
authors.lastname: Inagaki
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yamada
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D049528:Insulin, Long-Acting