title: Association between the secretory unit of islet transplant objects index and satisfaction with insulin therapy among insulin-dependent islet recipients.
abstract: BACKGROUND
  When patients do not become insulin independent after islet cell transplantation (ICT), another aim is to eliminate severe hypoglycemia. Previously we reported that a secretory unit of islet transplant objects (SUITO) index score >10 was associated with a reduction of severe hypoglycemia. In this study, we assessed patients' satisfaction with their insulin therapy based on the SUITO index.
  
  
  METHODS
  The study involved 11 islet recipients with type 1 diabetes who underwent ICT but still used insulin. From those patients, 41 Insulin Therapy Satisfaction Questionnaires (ITSQ) were collected. The SUITO index (fasting C-peptide [ng/mL] × 1500/blood glucose [mg/dL] - 63) was calculated at the same outpatient visits that the survey was administered. ITSQ scores were summarized using subscales and compared among 3 groups: the pre-ICT group, the low-SUITO group (SUITO index score <10 post-ICT), and the high-SUITO group (SUITO index score ≥10). Higher survey scores indicated better satisfaction.
  
  
  RESULTS
  Significant trend relationships across the 3 groups were observed in the ITSQ total score (P = .02 with Jonckheere-Terpstra test) and subscale scores of glycemic control (P < .001), hypoglycemic control (P = .01), and inconvenience of regimen (P = .004). The pairwise comparisons between the 3 groups found significant differences: high SUITO versus both pre-ICT and low SUITO for the total ITSQ score (P = .03 and .005, respectively) and glycemic control score (P = .008 and .001, respectively), and high SUITO versus low SUITO for hypoglycemic control score (P = .04) and inconvenience of regimen score (P = .008).
  
  
  CONCLUSIONS
  Islet recipients with a SUITO index ≥10 experienced higher satisfaction with insulin injection therapy compared with the pre-ICT group, even though they were insulin dependent. A SUITO index ≥10 is a reasonable benchmark for successful ICT.
authors.affiliation: Baylor Research Institute, Islet Cell Laboratory, Dallas, Texas, USA.
authors.forename: M
authors.initials: M
authors.lastname: Takita
authors.forename: S
authors.initials: S
authors.lastname: Matsumoto
authors.forename: M
authors.initials: M
authors.lastname: Shimoda
authors.forename: D
authors.initials: D
authors.lastname: Chujo
authors.forename: T
authors.initials: T
authors.lastname: Itoh
authors.forename: S
authors.initials: S
authors.lastname: Iwahashi
authors.forename: J A
authors.initials: JA
authors.lastname: SoRelle
authors.forename: N
authors.initials: N
authors.lastname: Onaca
authors.forename: B
authors.initials: B
authors.lastname: Naziruddin
authors.forename: M F
authors.initials: MF
authors.lastname: Levy
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007003:Hypoglycemia / Q000628:therapy; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use*; D007515:Islets of Langerhans / Q000166:cytology*; D016381:Islets of Langerhans Transplantation / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin