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Title: Long-term outcome of islet transplantation on insulin-dependent diabetes mellitus: An observational cohort study
Authors: Nakamura, Toshihiro
Fujikura, Junji
Anazawa, Takayuki
Ito, Ryo
Ogura, Masahito  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-7107-2752 (unconfirmed)
Okajima, Hideaki
Uemoto, Shinji
Inagaki, Nobuya
Author's alias: 藤倉, 純二
穴澤, 貴行
小倉, 雅仁
岡島, 英明
上本, 伸二
稲垣, 暢也
Keywords: Insulin‐dependent diabetes mellitus
Islet transplantation
Long‐term outcome
Issue Date: Mar-2020
Publisher: Wiley
Journal title: Journal of Diabetes Investigation
Volume: 11
Issue: 2
Start page: 363
End page: 372
Abstract: Aims/Introduction: Among 619 patients diagnosed as insulin‐dependent diabetes mellitus or type 1 diabetes at Kyoto University, Kyoto, Japan, seven patients were selected as the ITx group and 26 age‐matched patients with no endogenous insulin secretion were selected as the MDI/CSII group. Hemoglobin A1c, aspartate aminotransferase/alanine aminotransferase (AST/ALT) and creatinine were assessed retrospectively at 1, 2, 5 and 10 years for both groups; serum C‐peptide immunoreactivity was assessed for the ITx group. Major clinical events were also assessed. Results: Hemoglobin A1c improvement in ITx was significant at 1 year (8.4% [7.8–9.9%] at baseline to 7.1% [6.3–7.4%] in ITx vs 8.2% [7.4–9.8%] at baseline to 8.1% [7.3–9.5%] in MDI/CSII, P < 0.01 between groups), and was maintained at 2 years (7.4% [6.3–8.2%] vs 8.4% [7.4–9.6%], P = 0.11). The increase of stimulated C‐peptide immunoreactivity was significant at 1 year (0.57 ng/mL [0.26–0.99 ng/mL], P < 0.05 from baseline) and 2 years (0.43 ng/mL [0.19–0.67 ng/mL], P < 0.05), although it became insignificant thereafter. There was no significant difference in AST/ALT or creatinine at 10 years, although a transient AST/ALT elevation was observed in ITx. In regard to clinical events, the occurrence of severe hypoglycemia was 14% vs 31% (relative risk 0.46, P = 0.64), that of infectious disease was 43% vs 12% (relative risk 3.71, P = 0.09) and digestive symptoms was 43% vs 7.7% (relative risk 5.57, P = 0.05) in ITx vs MDI/CSII, respectively. No patient died in either group. Conclusions: The present findings showed that ITx was considered to contribute to the reduction of hypoglycemia and better glycemic control with tolerable, but attention‐requiring, risks over a period of 10 years compared with MDI/CSII.
Rights: © 2019 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
URI: http://hdl.handle.net/2433/255882
DOI(Published Version): 10.1111/jdi.13128
PubMed ID: 31390159
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