Islet transplantation stabilizes hemostatic abnormalities and cerebral metabolism in individuals with type 1 diabetes

Francesca D'Addio, Paola Maffi, Paolo Vezzulli, Andrea Vergani, Alessandra Mello, Roberto Bassi, Rita Nano, Monica Falautano, Elisabetta Coppi, Giovanna Finzi, Armando D'Angelo, Isabella Fermo, Fabio Pellegatta, Stefano La Rosa, Giuseppe Magnani, Lorenzo Piemonti, Andrea Falini, Franco Folli, Antonio Secchi, Paolo Fiorina

Research output: Contribution to journalArticle

Abstract

Objective Islets after kidney transplantation have been shown to positively affect the quality of life of individuals with type 1 diabetes (T1D) by reducing the burden of diabetes complications, but fewer data are available for islet transplantation alone (ITA). The aim of this study was to assess whether ITA has a positive impact on hemostatic and cerebral abnormalities in individuals with T1D. Research Design And Methods Prothrombotic factors, platelet function/ultrastructure, and cerebral morphology, metabolism, and function have been investigated over a 15-month follow-up period using ELISA/electronmicroscopy and magnetic resonance imaging, nuclear magnetic resonance spectroscopy, and neuropsychological evaluation (Profile of Mood States test and paced auditory serial addition test) in 22 individuals with T1D who underwent ITA (n = 12) or remained on the waiting list (n = 10). Patients were homogeneous with regard to metabolic criteria, hemostatic parameters, and cerebral morphology/metabolism/function at the time of enrollment on the waiting list. Results At the 15-month follow-up, the group undergoing ITA, but not individuals with T1D who remained on the waiting list, showed 1) improved glucose metabolism; 2) near-normal platelet activation and prothrombotic factor levels; 3) near-normal cerebral metabolism and function; and 4) a near-normal neuropsychological test. Conclusions ITA, despite immunosuppressive therapy, is associated with a near-normalization of hemostatic and cerebral abnormalities.

Original languageEnglish
Pages (from-to)267-276
Number of pages10
JournalDiabetes Care
Volume37
Issue number1
DOIs
Publication statusPublished - Jan 2014

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Islets of Langerhans Transplantation
Hemostatics
Type 1 Diabetes Mellitus
Waiting Lists
Neuropsychological Tests
Platelet Activation
Diabetes Complications
Immunosuppressive Agents
Kidney Transplantation
Research Design
Magnetic Resonance Spectroscopy
Blood Platelets
Enzyme-Linked Immunosorbent Assay
Quality of Life
Magnetic Resonance Imaging
Glucose

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Islet transplantation stabilizes hemostatic abnormalities and cerebral metabolism in individuals with type 1 diabetes. / D'Addio, Francesca; Maffi, Paola; Vezzulli, Paolo; Vergani, Andrea; Mello, Alessandra; Bassi, Roberto; Nano, Rita; Falautano, Monica; Coppi, Elisabetta; Finzi, Giovanna; D'Angelo, Armando; Fermo, Isabella; Pellegatta, Fabio; La Rosa, Stefano; Magnani, Giuseppe; Piemonti, Lorenzo; Falini, Andrea; Folli, Franco; Secchi, Antonio; Fiorina, Paolo.

In: Diabetes Care, Vol. 37, No. 1, 01.2014, p. 267-276.

Research output: Contribution to journalArticle

D'Addio, Francesca ; Maffi, Paola ; Vezzulli, Paolo ; Vergani, Andrea ; Mello, Alessandra ; Bassi, Roberto ; Nano, Rita ; Falautano, Monica ; Coppi, Elisabetta ; Finzi, Giovanna ; D'Angelo, Armando ; Fermo, Isabella ; Pellegatta, Fabio ; La Rosa, Stefano ; Magnani, Giuseppe ; Piemonti, Lorenzo ; Falini, Andrea ; Folli, Franco ; Secchi, Antonio ; Fiorina, Paolo. / Islet transplantation stabilizes hemostatic abnormalities and cerebral metabolism in individuals with type 1 diabetes. In: Diabetes Care. 2014 ; Vol. 37, No. 1. pp. 267-276.
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abstract = "Objective Islets after kidney transplantation have been shown to positively affect the quality of life of individuals with type 1 diabetes (T1D) by reducing the burden of diabetes complications, but fewer data are available for islet transplantation alone (ITA). The aim of this study was to assess whether ITA has a positive impact on hemostatic and cerebral abnormalities in individuals with T1D. Research Design And Methods Prothrombotic factors, platelet function/ultrastructure, and cerebral morphology, metabolism, and function have been investigated over a 15-month follow-up period using ELISA/electronmicroscopy and magnetic resonance imaging, nuclear magnetic resonance spectroscopy, and neuropsychological evaluation (Profile of Mood States test and paced auditory serial addition test) in 22 individuals with T1D who underwent ITA (n = 12) or remained on the waiting list (n = 10). Patients were homogeneous with regard to metabolic criteria, hemostatic parameters, and cerebral morphology/metabolism/function at the time of enrollment on the waiting list. Results At the 15-month follow-up, the group undergoing ITA, but not individuals with T1D who remained on the waiting list, showed 1) improved glucose metabolism; 2) near-normal platelet activation and prothrombotic factor levels; 3) near-normal cerebral metabolism and function; and 4) a near-normal neuropsychological test. Conclusions ITA, despite immunosuppressive therapy, is associated with a near-normalization of hemostatic and cerebral abnormalities.",
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T1 - Islet transplantation stabilizes hemostatic abnormalities and cerebral metabolism in individuals with type 1 diabetes

AU - D'Addio, Francesca

AU - Maffi, Paola

AU - Vezzulli, Paolo

AU - Vergani, Andrea

AU - Mello, Alessandra

AU - Bassi, Roberto

AU - Nano, Rita

AU - Falautano, Monica

AU - Coppi, Elisabetta

AU - Finzi, Giovanna

AU - D'Angelo, Armando

AU - Fermo, Isabella

AU - Pellegatta, Fabio

AU - La Rosa, Stefano

AU - Magnani, Giuseppe

AU - Piemonti, Lorenzo

AU - Falini, Andrea

AU - Folli, Franco

AU - Secchi, Antonio

AU - Fiorina, Paolo

PY - 2014/1

Y1 - 2014/1

N2 - Objective Islets after kidney transplantation have been shown to positively affect the quality of life of individuals with type 1 diabetes (T1D) by reducing the burden of diabetes complications, but fewer data are available for islet transplantation alone (ITA). The aim of this study was to assess whether ITA has a positive impact on hemostatic and cerebral abnormalities in individuals with T1D. Research Design And Methods Prothrombotic factors, platelet function/ultrastructure, and cerebral morphology, metabolism, and function have been investigated over a 15-month follow-up period using ELISA/electronmicroscopy and magnetic resonance imaging, nuclear magnetic resonance spectroscopy, and neuropsychological evaluation (Profile of Mood States test and paced auditory serial addition test) in 22 individuals with T1D who underwent ITA (n = 12) or remained on the waiting list (n = 10). Patients were homogeneous with regard to metabolic criteria, hemostatic parameters, and cerebral morphology/metabolism/function at the time of enrollment on the waiting list. Results At the 15-month follow-up, the group undergoing ITA, but not individuals with T1D who remained on the waiting list, showed 1) improved glucose metabolism; 2) near-normal platelet activation and prothrombotic factor levels; 3) near-normal cerebral metabolism and function; and 4) a near-normal neuropsychological test. Conclusions ITA, despite immunosuppressive therapy, is associated with a near-normalization of hemostatic and cerebral abnormalities.

AB - Objective Islets after kidney transplantation have been shown to positively affect the quality of life of individuals with type 1 diabetes (T1D) by reducing the burden of diabetes complications, but fewer data are available for islet transplantation alone (ITA). The aim of this study was to assess whether ITA has a positive impact on hemostatic and cerebral abnormalities in individuals with T1D. Research Design And Methods Prothrombotic factors, platelet function/ultrastructure, and cerebral morphology, metabolism, and function have been investigated over a 15-month follow-up period using ELISA/electronmicroscopy and magnetic resonance imaging, nuclear magnetic resonance spectroscopy, and neuropsychological evaluation (Profile of Mood States test and paced auditory serial addition test) in 22 individuals with T1D who underwent ITA (n = 12) or remained on the waiting list (n = 10). Patients were homogeneous with regard to metabolic criteria, hemostatic parameters, and cerebral morphology/metabolism/function at the time of enrollment on the waiting list. Results At the 15-month follow-up, the group undergoing ITA, but not individuals with T1D who remained on the waiting list, showed 1) improved glucose metabolism; 2) near-normal platelet activation and prothrombotic factor levels; 3) near-normal cerebral metabolism and function; and 4) a near-normal neuropsychological test. Conclusions ITA, despite immunosuppressive therapy, is associated with a near-normalization of hemostatic and cerebral abnormalities.

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