Insulin secretory patterns and blood glucose homeostasis after islet allotransplantation in IDDM patients: Comparison with segmental- or whole- pancreas transplanted patients through a long term longitudinal study

Antonio Secchi, Maria Vittoria Taglietti, Carlo Socci, Paola Maffi, Luca Falqui, Rossana Caldara, Valerio Di Carlo, Guido Pozza

Research output: Contribution to journalArticle

Abstract

IDDM patients undergoing islet, segmental pancreas or whole pancreas allotransplantation were studied at regular intervals after surgery (3-6 months, 1, 2, 3 and 4 years) to evaluate glycometabolic control (24 h metabolic profile, OGTT) and serum free insulin response to insulinogenic stimuli (arginine, IVGTT). Patients received the same immunosuppressive therapy, based on cyclosporin, steroids and azathioprine. Islet transplanted patients showed: 1) an early peak of insulin secretion after arginine, that was maintained up to 4 years; 2) an early, but low peak of insulin secretion after IVGTT, which was lost at 3 years, despite evidence that islets were still functioning (insulin independence with normal HbAlc levels); 3) a diabetic-like response to OGTT at 3 months, which improved at 2 years (IGT response); 4) fasting euglycemia with mild and reversible post-prandial hyperglycemia during the 24 h metabolic profile, which was maintained for up to 2 years. Insulin secretory patterns of islet transplanted patients were similar to segmental pancreas transplanted patients, and lower than whole pancreas transplanted patients. The reduced beta cell mass transplanted and the functional denervation of the transplanted islets seem to be the major determinants of this behaviour.

Original languageEnglish
Pages (from-to)133-139
Number of pages7
JournalJournal of Molecular Medicine
Volume77
Issue number1
Publication statusPublished - 1999

Keywords

  • Arginine test
  • Islet transplantation
  • IVGTT
  • OGTT Metabolic profiles
  • Pancreas transplantation
  • Serum insulin

ASJC Scopus subject areas

  • Medicine(all)

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