Restoration of hypoglycemia awareness after islet transplantation

Cristiane B. Leitão, Thipaporn Tharavanij, Pablo Cure, Antonello Pileggi, David Baidal, Camillo Ricordi, Rodolfo Alejandro

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

OBJECTIVE - To determine the impact of islet transplantation (ITx) on hypoglycemia awareness in patients with unstable type 1 diabetes and its relation to islet function. RESEARCH DESIGN AND METHODS - A total of 31 ITx recipients were studied. Hypoglycemia unawareness was assessed using the Clarke hypoglycemic score (0 = no hypoglycemia; ≥4 = hypoglycemia unawareness). Subjects were grouped based on graft function: off-insulin (n = 8), graft dysfunction (on-insulin and stimulated C-peptide ≥0.3 ng/ml, n = 13), and graft failure (stimulated C-peptide <0.3 ng/ml, n = 10, evaluated 11.5 ± 14.5 months after graft failure). RESULTS - The hypoglycemia score improved after ITx when compared with baseline values (before vs. after: 5.29 ± 1.51 vs. 1.35 ± 1.92, P < 0.001). This result was sustained even after patient stratification based on islet function (pre vs. post off-insulin: 5.63 ± 2.00 vs. no hypoglycemia reported; graft dysfunction: 5.31 ± 1.49 vs. 1.15 ± 1.63, P < 0.001; and graft failure: 5.00 ± 1.16 vs. 2.70 ± 2.26, P = 0.014). CONCLUSIONS - The improved metabolic control achieved with ITx can restore hypo- glycemia awareness in patients with type 1 diabetes, persisting even after islet graft failure.

Original languageEnglish
Pages (from-to)2113-2115
Number of pages3
JournalDiabetes Care
Volume31
Issue number11
DOIs
StatePublished - Nov 1 2008

Fingerprint

Islets of Langerhans Transplantation
Hypoglycemia
Transplants
C-Peptide
Insulin
Type 1 Diabetes Mellitus
Hypoglycemic Agents
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Restoration of hypoglycemia awareness after islet transplantation. / Leitão, Cristiane B.; Tharavanij, Thipaporn; Cure, Pablo; Pileggi, Antonello; Baidal, David; Ricordi, Camillo; Alejandro, Rodolfo.

In: Diabetes Care, Vol. 31, No. 11, 01.11.2008, p. 2113-2115.

Research output: Contribution to journalArticle

Leitão, Cristiane B. ; Tharavanij, Thipaporn ; Cure, Pablo ; Pileggi, Antonello ; Baidal, David ; Ricordi, Camillo ; Alejandro, Rodolfo. / Restoration of hypoglycemia awareness after islet transplantation. In: Diabetes Care. 2008 ; Vol. 31, No. 11. pp. 2113-2115.
@article{18868f5a8a5f4571a94d53c966d4d172,
title = "Restoration of hypoglycemia awareness after islet transplantation",
abstract = "OBJECTIVE - To determine the impact of islet transplantation (ITx) on hypoglycemia awareness in patients with unstable type 1 diabetes and its relation to islet function. RESEARCH DESIGN AND METHODS - A total of 31 ITx recipients were studied. Hypoglycemia unawareness was assessed using the Clarke hypoglycemic score (0 = no hypoglycemia; ≥4 = hypoglycemia unawareness). Subjects were grouped based on graft function: off-insulin (n = 8), graft dysfunction (on-insulin and stimulated C-peptide ≥0.3 ng/ml, n = 13), and graft failure (stimulated C-peptide <0.3 ng/ml, n = 10, evaluated 11.5 ± 14.5 months after graft failure). RESULTS - The hypoglycemia score improved after ITx when compared with baseline values (before vs. after: 5.29 ± 1.51 vs. 1.35 ± 1.92, P < 0.001). This result was sustained even after patient stratification based on islet function (pre vs. post off-insulin: 5.63 ± 2.00 vs. no hypoglycemia reported; graft dysfunction: 5.31 ± 1.49 vs. 1.15 ± 1.63, P < 0.001; and graft failure: 5.00 ± 1.16 vs. 2.70 ± 2.26, P = 0.014). CONCLUSIONS - The improved metabolic control achieved with ITx can restore hypo- glycemia awareness in patients with type 1 diabetes, persisting even after islet graft failure.",
author = "Leit{\~a}o, {Cristiane B.} and Thipaporn Tharavanij and Pablo Cure and Antonello Pileggi and David Baidal and Camillo Ricordi and Rodolfo Alejandro",
year = "2008",
month = "11",
day = "1",
doi = "10.2337/dc08-0741",
language = "English",
volume = "31",
pages = "2113--2115",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "11",

}

TY - JOUR

T1 - Restoration of hypoglycemia awareness after islet transplantation

AU - Leitão, Cristiane B.

AU - Tharavanij, Thipaporn

AU - Cure, Pablo

AU - Pileggi, Antonello

AU - Baidal, David

AU - Ricordi, Camillo

AU - Alejandro, Rodolfo

PY - 2008/11/1

Y1 - 2008/11/1

N2 - OBJECTIVE - To determine the impact of islet transplantation (ITx) on hypoglycemia awareness in patients with unstable type 1 diabetes and its relation to islet function. RESEARCH DESIGN AND METHODS - A total of 31 ITx recipients were studied. Hypoglycemia unawareness was assessed using the Clarke hypoglycemic score (0 = no hypoglycemia; ≥4 = hypoglycemia unawareness). Subjects were grouped based on graft function: off-insulin (n = 8), graft dysfunction (on-insulin and stimulated C-peptide ≥0.3 ng/ml, n = 13), and graft failure (stimulated C-peptide <0.3 ng/ml, n = 10, evaluated 11.5 ± 14.5 months after graft failure). RESULTS - The hypoglycemia score improved after ITx when compared with baseline values (before vs. after: 5.29 ± 1.51 vs. 1.35 ± 1.92, P < 0.001). This result was sustained even after patient stratification based on islet function (pre vs. post off-insulin: 5.63 ± 2.00 vs. no hypoglycemia reported; graft dysfunction: 5.31 ± 1.49 vs. 1.15 ± 1.63, P < 0.001; and graft failure: 5.00 ± 1.16 vs. 2.70 ± 2.26, P = 0.014). CONCLUSIONS - The improved metabolic control achieved with ITx can restore hypo- glycemia awareness in patients with type 1 diabetes, persisting even after islet graft failure.

AB - OBJECTIVE - To determine the impact of islet transplantation (ITx) on hypoglycemia awareness in patients with unstable type 1 diabetes and its relation to islet function. RESEARCH DESIGN AND METHODS - A total of 31 ITx recipients were studied. Hypoglycemia unawareness was assessed using the Clarke hypoglycemic score (0 = no hypoglycemia; ≥4 = hypoglycemia unawareness). Subjects were grouped based on graft function: off-insulin (n = 8), graft dysfunction (on-insulin and stimulated C-peptide ≥0.3 ng/ml, n = 13), and graft failure (stimulated C-peptide <0.3 ng/ml, n = 10, evaluated 11.5 ± 14.5 months after graft failure). RESULTS - The hypoglycemia score improved after ITx when compared with baseline values (before vs. after: 5.29 ± 1.51 vs. 1.35 ± 1.92, P < 0.001). This result was sustained even after patient stratification based on islet function (pre vs. post off-insulin: 5.63 ± 2.00 vs. no hypoglycemia reported; graft dysfunction: 5.31 ± 1.49 vs. 1.15 ± 1.63, P < 0.001; and graft failure: 5.00 ± 1.16 vs. 2.70 ± 2.26, P = 0.014). CONCLUSIONS - The improved metabolic control achieved with ITx can restore hypo- glycemia awareness in patients with type 1 diabetes, persisting even after islet graft failure.

UR - http://www.scopus.com/inward/record.url?scp=59249108588&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=59249108588&partnerID=8YFLogxK

U2 - 10.2337/dc08-0741

DO - 10.2337/dc08-0741

M3 - Article

C2 - 18697903

AN - SCOPUS:59249108588

VL - 31

SP - 2113

EP - 2115

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 11

ER -