Trial reportThe Journal of clinical endocrinology and metabolism2013
Improvement in insulin sensitivity after human islet transplantation for type 1 diabetes.
Trial report in The Journal of clinical endocrinology and metabolism, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Defining Outcomes for β-cell Replacement Therapy in the Treatment of Diabetes: A Consensus Report on the Igls Criteria From the IPITA/EPITA Opinion Leaders Workshop.Transplantation · 2018Guideline
- Mini-Dose Glucagon as a Novel Approach to Prevent Exercise-Induced Hypoglycemia in Type 1 Diabetes.Diabetes care · 2018Trial
- Metabolic effect of adrenaline infusion in people with type 1 diabetes and healthy individuals.Diabetologia · 2024Article
- Urine-derived stem cell therapy for diabetes mellitus and its complications: progress and challenges.Endocrine · 2024Review
- Article
- Extended survival versus accelerated rejection of nonhuman primate islet allografts: Effect of mesenchymal stem cell source and timing.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Article
- The Peripheral Peril: Injected Insulin Induces Insulin Insensitivity in Type 1 Diabetes.Diabetes · 2020Review
- High residual C-peptide likely contributes to glycemic control in type 1 diabetes.The Journal of clinical investigation · 2020Article
- Article
- Pancreatic Islet Transplantation in Humans: Recent Progress and Future Directions.Endocrine reviews · 2019Review
- Defining outcomes for β-cell replacement therapy in the treatment of diabetes: a consensus report on the Igls criteria from the IPITA/EPITA opinion leaders workshop.Transplant international : official journal of the European Society for Organ Transplantation · 2018Review
- Long term (4 years) improved insulin sensitivity following islet cell transplant in type 1 diabetes.Diabetes/metabolism research and reviews · 2018Article
- Early Intensive Insulin Use May PreserveJournal of the Endocrine Society · 2018Article
- The role of glycemia in insulin resistance in youth with type 1 and type 2 diabetes.Pediatric diabetes · 2017Article
- A Comparative Analysis of the Safety, Efficacy, and Cost of Islet Versus Pancreas Transplantation in Nonuremic Patients With Type 1 Diabetes.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2016Article
- Post-Transplant Diabetes Mellitus: Causes, Treatment, and Impact on Outcomes.Endocrine reviews · 2016Review
- Regenerative Therapy of Type 1 Diabetes Mellitus: From Pancreatic Islet Transplantation to Mesenchymal Stem Cells.Stem cells international · 2016Review
- Treating diet-induced diabetes and obesity with human embryonic stem cell-derived pancreatic progenitor cells and antidiabetic drugs.Stem cell reports · 2015Article
- Insulin sensitivity index in type 1 diabetes and following human islet transplantation: comparison of the minimal model to euglycemic clamp measures.American journal of physiology. Endocrinology and metabolism · 2014Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
contextIslet transplantation can improve metabolic control for type 1 diabetes (T1D), an effect anticipated to improve insulin sensitivity. However, current immunosuppression regimens containing tacrolimus and sirolimus have been shown to induce insulin resistance in rodents.
objectiveThe objective of the study was to evaluate the effect of islet transplantation on insulin sensitivity in T1D using euglycemic clamps with the isotopic dilution method to distinguish between effects at the liver and skeletal muscle. DESIGN, SETTING, AND
participantsTwelve T1D subjects underwent evaluation in the Clinical and Translational Research Center before and between 6 and 7 months after the transplant and were compared with normal control subjects.
interventionThe intervention included intrahepatic islet transplantation according to a Clinical Islet Transplantation Consortium protocol under low-dose tacrolimus and sirolimus immunosuppression.
main outcome measuresTotal body (M/Δinsulin), hepatic (1/endogenous glucose production ·basal insulin) and peripheral [(Rd - endogenous glucose production)/Δinsulin] insulin sensitivity assessed by hyperinsulinemic (1 mU·kg(-1)·min(-1)) euglycemic (∼90 mg/dL) clamps with 6,6-(2)H2-glucose tracer infusion were measured.
resultsGlycosylated hemoglobin was reduced in the transplant recipients from 7.0% ± 0.3% to 5.6% ± 0.1% (P < .01). There were increases in total (0.11 ± 0.01 to 0.15 ± 0.02 dL/min·kg per microunit per milliliter), hepatic [2.3 ± 0.1 to 3.7 ± 0.4 × 10(2) ([milligrams per kilogram per minute](-1)·(microunits per milliliter)(-1))], and peripheral (0.08 ± 0.01 to 0.12 ± 0.02 dL/min·kg per microunit per milliliter) insulin sensitivity from before to after transplantation (P < .05 for all). All insulin sensitivity measures were less than normal in T1D before (P ≤ .05) and not different from normal after transplantation.
conclusionsIslet 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.
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