Stem cell transplantation associated with higher C-peptide levels in patients with type 1 diabetes

The majority of patients were insulin independent for various durations following transplantation procedure.

Patients with new-onset type 1 diabetes who received autologous nonmyeloablative hematopoietic stem cell transplantation had increased C-peptide levels and insulin independence, study results suggested.

Researchers enrolled 23 patients with newly diagnosed type 1 diabetes into the study. All patients underwent autologous nonmyeloablative hematopoietic stem cell transplantation. The researchers sought to determine if their insulin independence was due to improved beta-cell function by monitoring C-peptide levels in the population.

According to the study results, 20 of the 23 patients experienced insulin independence following the transplantation procedure (12 continuously and eight transiently). The researchers reported that patients remained continuously free of insulin for a mean time of 31 months, with one patient going at least four years without exogenous insulin, four patients going at least three years, three patients going at least two years and four patients making it at least one year.

The mean area under the curve for C-peptide levels prior to transplantation in the continuous insulin-independent group (225.0 ng/mL per two hours) increased at 24 months following implantation (785.4 ng/mL per two hours; P<.001) and at 36 months following transplantation (728.1 ng/mL per two hours; P=.001).

In the transient insulin-independent group, mean AUC of C-peptide levels increased from 148.9 ng/mL per two hours prior to transplantation to 546.8 ng/mL per two hours at 36 months (P=.001). Three patients did not experience any time free from insulin dependence.

“Besides tight glucose control, preservation of beta-cell mass is another important target in the management of type 1 diabetes and prevention of its complications,” Richard K. Burt, MD, chief of immunotherapy and associate professor of medicine at Northwestern University in Chicago, said during a press briefing held by the Journal of the American Medical Association in Washington, D.C. “The question was how to do that, and what we have shown in this study is that this procedure and this technology do in fact do that.” – by Eric Raible

For more information:

Couri CEB. JAMA. 2009;301:1573-1579.
Burt RK. C-peptide levels and insulin independence following stem cell transplantation in patients with newly diagnosed type 1 diabetes mellitus. Presented at: JAMA News Briefing; April 14, 2009; Washington D.C.