title: Restoration of hypoglycemia awareness after islet transplantation.
abstract: OBJECTIVE
  To determine the impact of islet transplantation (ITx) on hypoglycemia awareness in patients with unstable type 1 diabetes and its relation to islet function.
  
  
  METHODS
  A total of 31 ITx recipients were studied. Hypoglycemia unawareness was assessed using the Clarke hypoglycemic score (0 = no hypoglycemia; >or=4 = hypoglycemia unawareness). Subjects were grouped based on graft function: off-insulin (n = 8), graft dysfunction (on-insulin and stimulated C-peptide >or=0.3 ng/ml, n = 13), and graft failure (stimulated C-peptide <0.3 ng/ml, n = 10, evaluated 11.5 +/- 14.5 months after graft failure).
  
  
  RESULTS
  The hypoglycemia score improved after ITx when compared with baseline values (before vs. after: 5.29 +/- 1.51 vs. 1.35 +/- 1.92, P < 0.001). This result was sustained even after patient stratification based on islet function (pre vs. post off-insulin: 5.63 +/- 2.00 vs. no hypoglycemia reported; graft dysfunction: 5.31 +/- 1.49 vs. 1.15 +/- 1.63, P < 0.001; and graft failure: 5.00 +/- 1.16 vs. 2.70 +/- 2.26, P = 0.014).
  
  
  CONCLUSIONS
  The improved metabolic control achieved with ITx can restore hypoglycemia awareness in patients with type 1 diabetes, persisting even after islet graft failure.
authors.affiliation: Diabetes Research Institute, Miami, Florida, USA.
authors.forename: Cristiane B
authors.initials: CB
authors.lastname: Leitão
authors.forename: Thipaporn
authors.initials: T
authors.lastname: Tharavanij
authors.forename: Pablo
authors.initials: P
authors.lastname: Cure
authors.forename: Antonello
authors.initials: A
authors.lastname: Pileggi
authors.forename: David A
authors.initials: DA
authors.lastname: Baidal
authors.forename: Camillo
authors.initials: C
authors.lastname: Ricordi
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Alejandro
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000601:surgery; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000175:diagnosis; D016381:Islets of Langerhans Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose