title: Efficacy and safety of autologous bone marrow derived hematopoietic stem cell transplantation in patients with type 2 DM: A 15 months follow-up study.
abstract: BACKGROUND
  there are dearths of studies describing the effect of autologous bone marrow derived stem cell transplantation (ABMSCT) through targeted approach in Type 2 Diabetes Mellitus. This study reports the efficacy and safety of super-selective injection of ABMSCT in T2DM.
  
  
  METHODS
  Ten patients (8 men and 2 women) with T2DM, with duration of disease >5 years and with documented triple drug failure receiving insulin (0.7 U/Kg/day), metformin and pioglitazone underwent super-selective injection of stem cells into superior pancreaticoduodenal artery under fluoroscopic guidance. The primary outcome measure was decrease in insulin requirement by ≥50% (defined as responders), while secondary endpoints were improvement in glucagon stimulated C-peptide levels, changes in weight, HbA1c, lipid profile and quality of life (QOL) at the end of 15 months.
  
  
  RESULTS
  Six patients (60%) were 'responders' at 15 months of follow-up showing a reduction in mean insulin requirement by 74% as compared to baseline and one patient was off-insulin till the end of the study. Mean HbA1c reduction in 'responders' was 1.1% (8.1 ± 0.5% to 7.0 ± 0.6%, P = 0.03), accompanied with a significant improvement in glucagon stimulated C-peptide levels (P = 0.03), Homeostasis Model Assessment -β (P = 0.03) and QOL scores. However, 'non-responders' did not show any significant alterations in these parameters. No serious adverse events were noted.
  
  
  CONCLUSIONS
  Our observations indicate that ABMSCT is effective in management of T2DM and its efficacy is maintained over a period of 15 months without any adverse events. However, more number of patients and longer duration of follow-up are required to substantiate these observations.
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhansali
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: Vimal
authors.initials: V
authors.lastname: Upreti
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: Rama
authors.initials: R
authors.lastname: Walia
authors.affiliation: Department of Radiodiagnosis, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: Shobhit
authors.initials: S
authors.lastname: Bhansali
authors.affiliation: Department of Transfusion Medicine, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: R R
authors.initials: RR
authors.lastname: Sharma
authors.affiliation: Department of Psychiatry, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Grover
authors.affiliation: Department of Transfusion Medicine, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: Neelam
authors.initials: N
authors.lastname: Marwaha
authors.affiliation: Department of Radiodiagnosis, Post Graduate Institute of Medical Research and Education, Chandigarh, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
keywords: C-peptide; stem cells; β-cells