A single transplantation of the islets can produce glycemic stability and reduction of basal insulin requirement

Abstract 

We investigated glycemic stability and insulin requirement 1 month after a single transplantation of the islets from non-heart-beating donors or a living donor. Overall blood glucose levels decreased immediately after transplantation. The M-value and mean amplitude of glycemic excursions (MAGE) decreased significantly from 53.0 (range, 8.9–91.0) to 4.2 (0.6–8.8, P<0.05) and from 8.5mM (4.8–11.7) to 3.3mM (2.0–4.5, P<0.05), respectively. The values after transplantation were lower than the first quartile of 102 type 2 diabetic control patients. The estimated HbA_1c level decreased significantly from 7.9% (5.7–10.9) to 5.4% (4.7–5.9, P<0.05). The supplement of basal insulin decreased 43% from 0.31units/kg/day (0.16–0.37) to 0.18units/kg/day (0–0.22, P<0.05), while that of stimulated insulin did not decrease significantly, from 0.28units/kg/day (0.13–0.51) to 0.21units/kg/day (0–0.41). Thus, only one islet transplantation can be sufficient to attain metabolic stability, probably by effective supply of basal insulin secretion, sufficient to avoid life-threatening severe hypoglycemia and prevent or delay the progress of secondary complications of diabetes by decreasing the HbA_1c level.

Keywords: A single transplantation of the islets, Non-heart-beating donor, Living donor, Metabolic stability