358-OR: ß-Cell Function and Insulin Sensitivity with Islet Alone and Islet-after-Kidney Transplantation for Type 1 Diabetes in the Clinical Islet Transplantation (CIT) Consortium

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 358-OR
Author(s):  
MICHAEL R. RICKELS ◽  
THOMAS EGGERMAN ◽  
LEVENT BAYMAN ◽  
JULIE QIDWAI ◽  
JOSEPH NAJI ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Transplantation ◽  
Insulin Sensitivity ◽  
Islet Transplantation ◽  
Cell Function ◽  
Clinical Islet Transplantation

scholarly journals The Future of Clinical Islet Transplantation in the United States

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Michael F Knoll ◽  
Carmela A Knoll ◽  
Rita Bottino ◽  
Massimo Trucco ◽  
Suzanne Bertera ◽  
...  
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Type 1 Diabetes ◽  
Islet Transplantation ◽  
Drug Administration ◽  
The United States ◽  
Clinical Islet Transplantation ◽  
The World

Clinical islet transplantation was first realized over four decades ago at the University of Minnesota. Autologous islet transplantation is now widely recognized as a treatment to prevent diabetes in patients after pancreas excision and is offered at major transplant centers throughout the United States and the world. Type 1 diabetes represents a much larger demographic in which islet transplantation may benefit patients. Allogeneic islet transplantation can now offer similar outcomes to pancreas transplantation in a subset of patients with labile type 1 diabetes with less risk than whole organ transplantation. It is recognized as a standard of care in nations around the world but not in the United States, despite the important developmental role US scientists and physicians have played. Early reports of islet transplantation focused on insulin independence that proved to diminish over time. However, regardless of insulin status, islet transplantation provides benefits ranging from improved quality of life to reduction in diabetic complications. A National Institutes of Health sponsored multi-center Phase 3 Clinical Trial (CIT-07) demonstrated safety and efficacy, although the Food and Drug Administration chose to consider islets as a biologic that requires licensure, which makes offering the procedure in the clinic very challenging. Until regulations can be brought into communion with international standards, allogeneic islet transplantation in the United States is unlikely to match international levels of success and once promising programs are left to wither on the vine. Food and Drug Administration approval would open the door for third party medical reimbursement and allow many patients the opportunity to enjoy better health and quality of life. Establishment of clinical islet transplantation for type 1 diabetes would lead to optimizations in procedures making it more efficacious and cost effective while offering support for ongoing islet xenotransplantation studies that could bring islet transplantation to even more patients.

Clinical islet transplantation in type 1 diabetes mellitus: results of Australia's first trial

2006 ◽  
Vol 184 (5) ◽  
pp. 221-225 ◽  
Author(s):  
Philip J O’Connell ◽  
Wayne J Hawthorne ◽  
Brian J Nankivell ◽  
Anita T Patel ◽  
Stacey N Walters ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Islet Transplantation ◽  
Clinical Islet Transplantation

Effect of Exenatide on ?? Cell Function After Islet Transplantation in Type 1 Diabetes

2007 ◽  
Vol 83 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Khalid Al Ghofaili ◽  
Michelle Fung ◽  
Ziliang Ao ◽  
Mark Meloche ◽  
R Jean Shapiro ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Islet Transplantation ◽  
Cell Function

P1672IMPACT OF ISLET TRANSPLANTATION VERSUS INSULIN ALONE AFTER KIDNEY TRANSPLANTATION IN TYPE 1 DIABETES PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mehdi Maanaoui ◽  
Mikael Chetboun ◽  
Julie Kerr-Conte ◽  
Valery Gmyr ◽  
Thomas Hubert ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Transplantation ◽  
Islet Transplantation ◽  
Endocrine Function ◽  
Study Endpoint ◽  
Primary Study ◽  
Kidney Graft ◽  
Pancreatic Graft ◽  
Diabetes Patients

Abstract Background and Aims In patients with type 1 diabetes and end-stage renal disease, kidney transplantation improves both quality of life and survival. When simultaneous kidney-pancreas transplantation appears too invasive, or after failure of the pancreatic graft, an islet after kidney transplantation (IAK) may be considered to restore a stable endocrine function. The aim of our work was to assess the impact of islet transplantation on kidney transplantation outcomes versus insulin alone. Method In this retrospective parallel-arm cohort study in Lille, we included all type 1 diabetes patients who received a kidney graft from 2000 to 2017, followed by an islet transplantation after kidney (IAK) or not (kidney alone, KA). The primary study endpoint was the change of renal function (estimated glomerular filtration rate, eGFR). Secondary endpoints were glycemic control-related markers, such as HBA1c. Results During the period of study, 14 patients were included in the KA group versus 15 in the IAK group (including 5 after failure of a simultaneous pancreatic graft) were enrolled. At baseline, kidney donor sex, BMI, cause of death, cold ischemia time and recipient sex, waiting time on dialysis, type of dialysis, and number of previous kidney transplantation, were similar between the two groups. Yet, there were significant differences between KA and IAK, considering donor age (resp. 56.0±15.0 vs 35.2±13.7 years, p<0.001), use of perfusion machine (resp. 7 vs 0, p= 0.002), recipient age (resp. 55.7±5.7 vs 42.1±6.1, p<0.001), and recipient BMI (24.7± 1.8 vs 21.9±2.5 k/m? p=0.004). In IAK, the median (IQR) time between islet and kidney transplantation was 21.8 months (19.0 – 29.4). eGFR was not significantly different at baseline (IAK: 57.8±17.7 vs KA: 48.9±21.4 ml/min, p=0.22) but the decrease was significantly lower up to 5 years in the IAK group (IAK: 0.05±1.99 ml/min/year vs KA: -2.42±3.43 ml/min/year, p=0.03). HBA1c was similar at baseline in both groups (IAK: 7.8±1.6% versus KA: 7.9±1.1%, p=0.31), but significantly lower in the IAK group up to 5 years (IAK: 6.6±0.97% versus KA: 7.8±1.12%, p<0.001). Conclusion In patients with type 1 diabetes and a functioning kidney graft, IAK was associated with a better glucose control and a slower decrease of eGFR than standard insulin therapy. Our results suggest that IAK should be proposed to type 1 diabetes patients with a functional kidney graft.

Contribution of Pancreatic Alpha-Cell Function to Insulin Sensitivity and Glucose Variability in Type 1 Diabetes Patients

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1940-P
Author(s):  
NOBUYUKI TAKAHASHI ◽  
DAISUKE CHUJO ◽  
HIROSHI KAJIO ◽  
KOHJIRO UEKI
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Sensitivity ◽  
Cell Function ◽  
Glucose Variability ◽  
Alpha Cell ◽  
Pancreatic Alpha Cell ◽  
Alpha Cell Function ◽  
Diabetes Patients

Stem cell sources for clinical islet transplantation in type 1 diabetes: Embryonic and adult stem cells

2006 ◽  
Vol 67 (4) ◽  
pp. 909-913 ◽  
Author(s):  
Helena Miszta-Lane ◽  
Mohammadreza Mirbolooki ◽  
A.M. James Shapiro ◽  
Jonathan R.T. Lakey
Keyword(s):  
Stem Cells ◽  
Type 1 Diabetes ◽  
Stem Cell ◽  
Islet Transplantation ◽  
Adult Stem Cells ◽  
Clinical Islet Transplantation ◽  
Cell Sources

Pancreas Islet Transplantation in Patients With Type 1 Diabetes Mellitus After Kidney Transplantation

2005 ◽  
Vol 37 (3) ◽  
pp. 1443-1445 ◽  
Author(s):  
M. Gonzalez Molina ◽  
A. Alonso ◽  
R. Briones ◽  
N. Fernandez ◽  
A. Caballero ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Kidney Transplantation ◽  
Type 1 Diabetes Mellitus ◽  
Islet Transplantation ◽  
Pancreas Islet

scholarly journals Effects of delayed gastric emptying on postprandial glucose kinetics, insulin sensitivity, and β-cell function

2014 ◽  
Vol 307 (6) ◽  
pp. E494-E502 ◽  
Author(s):  
Ling Hinshaw ◽  
Michele Schiavon ◽  
Ashwini Mallad ◽  
Chiara Dalla Man ◽  
Rita Basu ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Gastric Emptying ◽  
Insulin Sensitivity ◽  
Delayed Gastric Emptying ◽  
Cell Function ◽  
Postprandial Glucose ◽  
Β Cell ◽  
C Peptide ◽  
Β Cell Function

Controlling meal-related glucose excursions continues to be a therapeutic challenge in diabetes mellitus. Mechanistic reasons for this need to be understood better to develop appropriate therapies. To investigate delayed gastric emptying effects on postprandial glucose turnover, insulin sensitivity, and β-cell responsivity and function, as a feasibility study prior to studying patients with type 1 diabetes, we used the triple tracer technique C-peptide and oral minimal model approach in healthy subjects. A single dose of 30 μg of pramlintide administered at the start of a mixed meal was used to delay gastric emptying rates. With delayed gastric emptying rates, peak rate of meal glucose appearance was delayed, and rate of endogenous glucose production (EGP) was lower. C-peptide and oral minimal models enabled the assessments of β-cell function, insulin sensitivity, and β-cell responsivity simultaneously. Delayed gastric emptying induced by pramlintide improved total insulin sensitivity and decreased total β-cell responsivity. However, β-cell function as measured by total disposition index did not change. The improved whole body insulin sensitivity coupled with lower rate of appearance of EGP with delayed gastric emptying provides experimental proof of the importance of evaluating pramlintide in artificial endocrine pancreas approaches to reduce postprandial blood glucose variability in patients with type 1 diabetes.

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