Reduced progression of diabetic microvascular complications with islet cell transplantation compared with intensive medical therapy.
BACKGROUND
The effect of islet cell transplantation (ICT) on the progression of diabetic microvascular complications is not well understood.


METHODS
We have conducted a prospective, crossover, cohort study comparing ICT with intensive medical therapy on the progression of diabetic nephropathy, retinopathy, and neuropathy.


RESULTS
The rate of decline in glomerular filtration rate is slower after ICT than on medical therapy. There was significantly more progression of retinopathy in medically treated patients than post-ICT. There was a nonsignificant trend for improved nerve conduction velocity post-ICT.


CONCLUSIONS
ICT is associated with less progression of microvascular complications than intensive medical therapy. Multicenter, randomized trials are needed to further study the role of ICT in slowing the progression of diabetic complications.
Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada. david.thompson@vch.ca
David M
DM
Thompson
Mark
M
Meloche
Ziliang
Z
Ao
Breay
B
Paty
Paul
P
Keown
R Jean
RJ
Shapiro
Stephen
S
Ho
Dan
D
Worsley
Michelle
M
Fung
Graydon
G
Meneilly
Iain
I
Begg
Mohammed
M
Al Mehthel
Joma
J
Kondi
Claire
C
Harris
Blake
B
Fensom
Sharon E
SE
Kozak
Suet On
SO
Tong
Mary
M
Trinh
Garth L
GL
Warnock
D000328:Adult; D015331:Cohort Studies; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use*; D016381:Islets of Langerhans Transplantation; D008297:Male; D055806:Microvessels / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin