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Islet transplantation improved glucose variability vs. insulin

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SAN FRANCISCO — Islet transplantation may be superior to standard medical therapy in controlling glucose variability, according to data presented at the American Diabetes Association’s 74th Scientific Sessions.

“Even people with very good glycemic control … still have significant variations in blood glucose levels; this variability has become of significant clinical interest,” Peter Senior, MD, PhD,  associate professor, division of endocrinology, department of medicine at the University of Alberta’s Diabetes Institute in Canada, said during a presentation here. “This study was designed to try and answer the question as to whether islet transplantation performs above and beyond modern insulin therapy.”

The researchers used a 6-day continuous glucose monitoring (CGM) system, iPro2 (Medtronic) in 17 islet transplantation recipients and 12 patients with type 1 diabetes who use intensive insulin therapy (IIT). The CGM system was used to compare blood glucose variability, according to Senior.

Eight of 17 islet recipients were insulin independent. Islet transplantation patients were older (aged 54 years vs. 28.6 years) with longer diabetes duration (38.5 years vs. 10.2 years), according to data.

The islet transplantation patients demonstrated lower CGM glucose (7.3 mmol/L vs. 8.7 mmol/L, P=.03); significantly lower glucose variability based on lower CGM standard deviation (1.7 mmol/L vs. 2.97 mmol/L, P=.0001); and spent less time in hyperglycemia (% time >10 mmol/L), according to data.

Additional data indicated that neither group spent significant time in hypoglycemia (<3 mmol/L), according to Senior.

The islet transplantation group also demonstrated lower glycemic liability index (1.8 mmol/L vs. 1.9 mmol/L, P=.001), and a lower continuous overlapping net glycemic action, according to the findings.

“Islet transplantation is superior to best medical therapy and restoration of endogenous insulin secretion may be very important to improve glycemic control and potentially improve long-term complications” Senior said. – by Samantha Costa

Disclosure: Senior reports consultancy fees with Medtronic.

For more information:

Senior P. Abstract 80-OR. Presented at: American Diabetes Association’s 74th Scientific Sessions; June 13-17, 2014; San Francisco.