Nutritional status and behavior in subjects with type 1 diabetes, before and after islet transplantation.
BACKGROUND
To investigate whether changes of nutritional status and behavior are associated with islet transplantation (ITx) and to assess their possible mechanisms.


METHODS
In this observational study, 52 subjects with type 1 diabetes, 30 of whom received ITx, underwent nutritional assessments. The study consisted of questionnaires complemented by a dietary intake recording, anthropometric measurements, and body composition analysis. Laboratory tests were also reviewed as part of the follow up.


RESULTS
After ITx, significant reductions in body weight (3.7 kg; P<0.0001), body mass index (1.39 kg/m2; P<0.0001), waist circumference (3.96 cm; P=0.006), and fat weight (3.28 kg; P<0.01) were observed. The average consumption of carbohydrate and protein were also lower than pretransplant, together with some micronutrients (vitamins B12 and B6, zinc, and phosphorus). Insulin administration and changes in A1C were not associated with a significant change in anthropometric measurements. Subjects on exenatide after ITx showed significantly lower weight and body mass index than those not taking exenatide.


CONCLUSIONS
ITx is associated with modifications in nutritional behavior and status. Drugs and health conditions are likely to be at least in part responsible for these changes, but a voluntary modification of eating habits by the patients also plays a role. Strict monitoring of nutritional parameters, counseling by experts in nutrition, and multivitamin/mineral supplement after ITx could be of benefit to the patients.
Poggioli
Raffaella
R
Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Enfield
Gwen
G
Messinger
Shari
S
Faradji
Raquel N
RN
Tharavanij
Thipaporn
T
Pisani
Leandro
L
Cure
Pablo
P
Ponte
Gaston
G
Baidal
David A
DA
Froud
Tatiana
T
Ricordi
Camillo
C
Alejandro
Rodolfo
R
D000328:Adult; D015992:Body Mass Index; D016026:Bone Marrow Transplantation / Q000502:physiology / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery*; D003927:Diet, Diabetic; D002149:Energy Intake; D000077270:Exenatide; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007407:Interviews as Topic; D016381:Islets of Langerhans Transplantation / Q000502:physiology* / Q000523:psychology*; D016030:Kidney Transplantation / Q000502:physiology / Q000523:psychology; D009752:Nutritional Status; D010455:Peptides / Q000627:therapeutic use; D010465:Perception; D011795:Surveys and Questionnaires; D014688:Venoms / Q000627:therapeutic use
D007004:Hypoglycemic Agents; D007328:Insulin; D010455:Peptides; D014688:Venoms; D000077270:Exenatide