scholarly journals Mortality in People With Type 1 Diabetes, Severe Hypoglycemia, and Impaired Awareness of Hypoglycemia Referred for Islet Transplantation

2018 ◽  
Vol 4 (11) ◽  
pp. e401 ◽  
Author(s):  
Melissa H. Lee ◽  
Glenn M. Ward ◽  
Richard J. MacIsaac ◽  
Kathy Howe ◽  
D. Jane Holmes-Walker ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Islet Transplantation ◽  
Severe Hypoglycemia ◽  
Impaired Awareness

scholarly journals Predictors of Recurrent Severe Hypoglycemia in Adults With Type 1 Diabetes and Impaired Awareness of Hypoglycemia During the HypoCOMPaSS Study

Diabetes Care ◽  
2019 ◽  
Vol 43 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Anneliese J.S. Flatt ◽  
Stuart A. Little ◽  
Jane Speight ◽  
Lalantha Leelarathna ◽  
Emma Walkinshaw ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Severe Hypoglycemia ◽  
Impaired Awareness

Progress in Translational Regulatory T Cell Therapies for Type 1 Diabetes and Islet Transplantation

2020 ◽  
Author(s):  
Braulio A Marfil-Garza ◽  
Joshua Hefler ◽  
Mario Bermudez De Leon ◽  
Rena Pawlick ◽  
Nidheesh Dadheech ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Islet Transplantation ◽  
Ex Vivo ◽  
Severe Hypoglycemia ◽  
Cell Therapies ◽  
Current State ◽  
Cellular Transplantation ◽  
And Function

Abstract Regulatory T cells (Tregs) have become highly relevant in the pathophysiology and treatment of autoimmune diseases, such as type 1 diabetes (T1D). As these cells are known to be defective in T1D, recent efforts have explored ex vivo and in vivo Treg expansion and enhancement as a means for restoring self-tolerance in this disease. Given their capacity to also modulate alloimmune responses, studies using Treg-based therapies have recently been undertaken in transplantation. Islet transplantation provides a unique opportunity to study the critical immunological crossroads between auto- and alloimmunity. This procedure has advanced greatly in recent years, and reports of complete abrogation of severe hypoglycemia and long-term insulin independence have become increasingly reported. It is clear that cellular transplantation has the potential to be a true cure in T1D, provided the remaining barriers of cell supply and abrogated need for immune suppression can be overcome. However, the role that Tregs play in islet transplantation remains to be defined. Herein, we synthesize the progress and current state of Treg-based therapies in T1D and islet transplantation. We provide an extensive, but concise, background to understand the physiology and function of these cells and discuss the clinical evidence supporting potency and potential Treg-based therapies in the context of T1D and islet transplantation. Finally, we discuss some areas of opportunity and potential research avenues to guide effective future clinical application. This review provides a basic framework of knowledge for clinicians and researchers involved in the care of patients with T1D and islet transplantation.

scholarly journals Improved Health-Related Quality of Life in a Phase 3 Islet Transplantation Trial in Type 1 Diabetes Complicated by Severe Hypoglycemia

Diabetes Care ◽  
2018 ◽  
Vol 41 (5) ◽  
pp. 1001-1008 ◽  
Author(s):  
Eric D. Foster ◽  
Nancy D. Bridges ◽  
Irene D. Feurer ◽  
Thomas L. Eggerman ◽  
Lawrence G. Hunsicker ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Islet Transplantation ◽  
Severe Hypoglycemia ◽  
Health Related Quality ◽  
Phase 3 ◽  
Related Quality ◽  
Health Related

scholarly journals The Impact of Severe Hypoglycemia and Impaired Awareness of Hypoglycemia on Relatives of Patients With Type 1 Diabetes

Diabetes Care ◽  
2003 ◽  
Vol 26 (4) ◽  
pp. 1106-1109 ◽  
Author(s):  
H. V. Jorgensen ◽  
U. Pedersen-Bjergaard ◽  
A. K. Rasmussen ◽  
K. Borch-Johnsen
Keyword(s):  
Type 1 Diabetes ◽  
Severe Hypoglycemia ◽  
Impaired Awareness ◽  
The Impact

Structural Gray and White Matter Differences in Patients With Type 1 Diabetes and Impaired Awareness of Hypoglycemia

2020 ◽  
Author(s):  
Nicole Stantonyonge ◽  
Frederic Sampedro ◽  
Jorge Méndez ◽  
Saül Martínez-Horta ◽  
Ana Chico ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
White Matter ◽  
Severe Hypoglycemia ◽  
Population Based ◽  
Cortical Surface ◽  
Cross Sectional ◽  
Increased Risk ◽  
Impaired Awareness ◽  
Brain Changes

Abstract Context Type 1 diabetes (T1D) is associated with an increased risk of cognitive decline, where severe hypoglycemia (SH) and impaired awareness of hypoglycemia (IAH) may play a role. While there is evidence of a possible association between IAH and brain damage, the potential brain changes remain poorly characterized by magnetic resonance imaging (MRI). Objective To investigate whether there are structural brain differences in a group of T1D patients with IAH compared with normal awareness of hypoglycemia (NAH). Design General practice, population-based, cross-sectional study (July 2018 to July 2019). Setting Endocrinology Department, Hospital Santa Creu i Sant Pau. Participants A total of 40 T1D patients (20 each with IAH and NAH) matched for age, sex, T1D duration, and education level. Main Outcome Measures Using different neuroimaging techniques, we compared whole-brain gray matter (GM) and white matter (WM) differences. We used voxel-based morphometry and cortical surface area analysis methods to assess GM differences, and fractional anisotropy (FA) to assess WM differences. Results Compared with patients with T1D-NAH, patients with T1D-IAH had reduced GM volumes and cortical surface areas, especially in frontal and parietal regions (P < 0.05 corrected), and also showed reduced FA values in major WM tracts. The observed MRI differences correlated with both SH frequency and IAH severity. Conclusions MRI for patients with T1D show that IAH is associated with brain changes involving both GM and WM. Further research is needed to elucidate whether the observed differences are a consequence of increased SH episode frequency and increased IAH severity.

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