Improvement in Insulin Sensitivity After Human Islet Transplantation for Type 1 Diabetes

Rickels, Michael R.; Kong, Stephanie; Fuller, Carissa; Dalton-Bakes, Cornelia; Ferguson, Jane F.; Teff, Karen L.; Naji, Ali

doi:10.1210/jc.2013-1764

Cited by 34 publications

(26 citation statements)

References 20 publications

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“…Notably, at 2 to 3 weeks after transplant, insulin sensitivity was unchanged in these animals compared to their naive state before streptozotocin treatment (97,98). Finally, studies 6 to 7 months after human islet transplant treated with low-dose tacrolimus and sirolimus immunosuppression also suggested normal insulin sensitivity at the liver and skeletal muscle (99).…”

Section: Role Of Immunosuppression Agentsmentioning

confidence: 80%

Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes

Shivaswamy

Boerner

Larsen³

2015

Endocrine Reviews

249

203

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and VA Nebraska-Western Iowa Health Care System (V.S.), Omaha, Nebraska 68105Post-transplant diabetes mellitus (PTDM) is a frequent consequence of solid organ transplantation. PTDM has been associated with greater mortality and increased infections in different transplant groups using different diagnostic criteria. An international consensus panel recommended a consistent set of guidelines in 2003 based on American Diabetes Association glucose criteria but did not exclude the immediate post-transplant hospitalization when many patients receive large doses of corticosteroids. Greater glucose monitoring during all hospitalizations has revealed significant glucose intolerance in the majority of recipients immediately after transplant. As a result, the international consensus panel reviewed its earlier guidelines and recommended delaying screening and diagnosis of PTDM until the recipient is on stable doses of immunosuppression after discharge from initial transplant hospitalization. The group cautioned that whereas hemoglobin A1C has been adopted as a diagnostic criterion by many, it is not reliable as the sole diabetes screening method during the first year after transplant. Risk factors for PTDM include many of the immunosuppressant medications themselves as well as those for type 2 diabetes. The provider managing diabetes and associated dyslipidemia and hypertension after transplant must be careful of the greater risk for drug-drug interactions and infections with immunosuppressant medications. Treatment goals and therapies must consider the greater risk for fluctuating and reduced kidney function, which can cause hypoglycemia. Research is actively focused on strategies to prevent PTDM, but until strategies are found, it is imperative that immunosuppression regimens are chosen based on their evidence to prolong graft survival, not to avoid PTDM. (Endocrine Reviews 37: 37-61, 2016)

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Section: Role Of Immunosuppression Agentsmentioning

confidence: 80%

Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes

Shivaswamy

Boerner

Larsen³

2015

Endocrine Reviews

249

203

View full text Add to dashboard Cite

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“…Plasma glucagon and insulin levels were measured in duplicate by double antibody radioimmunoassays (Millipore, Billerica, MA). We have previously demonstrated that this insulin assay performs reliably in the presence of insulin autoantibodies, except in rare cases of extremely high-titer insulin autoantibodies where assay interference is readily apparent (18). The plasma lactate level was measured in duplicate using an automated lactate analyzer (YSI 2900; Yellow Springs Instruments).…”

Section: Biochemical Analysismentioning

confidence: 99%

Mini-Dose Glucagon as a Novel Approach to Prevent Exercise-Induced Hypoglycemia in Type 1 Diabetes

et al. 2018

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“…Previous studies have shown that glucotoxicity could modify IR in patients with T1D with HbA 1c levels above 10% . With decrease of HbA 1c from 8% to 6%, IR improved significantly after islet transplantation, which was attributed to normalization of blood glucose level and restoration of suppression of free fatty acids …”

Section: Discussionmentioning

confidence: 92%

A new model to estimate insulin resistance via clinical parameters in adults with type 1 diabetes

Zheng

Huang

Luo

et al. 2017

Diabetes Metabolism Res

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Improvement in Insulin Sensitivity After Human Islet Transplantation for Type 1 Diabetes

Abstract: Islet transplantation results in improved insulin sensitivity mediated by effects at both the liver and skeletal muscle. Modern dosing of glucocorticoid-free immunosuppression with low-dose tacrolimus and sirolimus does not induce insulin resistance in this population.

Cited by 34 publications

References 20 publications

Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes

Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes

Mini-Dose Glucagon as a Novel Approach to Prevent Exercise-Induced Hypoglycemia in Type 1 Diabetes

A new model to estimate insulin resistance via clinical parameters in adults with type 1 diabetes

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