Skip to main content
  • More from ADA
    • Diabetes Care
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care in Diabetes
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care
  • Subscribe
  • Log in
  • My Cart
  • Follow ada on Twitter
  • RSS
  • Visit ada on Facebook
Diabetes

Advanced Search

Main menu

  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • ADA Scientific Sessions Abstracts
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • ADA Scientific Sessions Abstracts
    • Diabetes COVID-19 Article Collection
    • Diabetes Symposium 2020
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Submit Cover Art
    • ADA Journal Policies
    • Instructions for Authors
    • ADA Peer Review
  • More from ADA
    • Diabetes Care
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care in Diabetes
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care

User menu

  • Subscribe
  • Log in
  • My Cart

Search

  • Advanced search
Diabetes
  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • ADA Scientific Sessions Abstracts
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • ADA Scientific Sessions Abstracts
    • Diabetes COVID-19 Article Collection
    • Diabetes Symposium 2020
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Submit Cover Art
    • ADA Journal Policies
    • Instructions for Authors
    • ADA Peer Review
Islet Studies

Successful Islet Transplantation

Continued Insulin Reserve Provides Long-Term Glycemic Control

  1. Edmond A. Ryan1,
  2. Jonathan R.T. Lakey23,
  3. Breay W. Paty1,
  4. Sharleen Imes4,
  5. Gregory S. Korbutt3,
  6. Norman M. Kneteman2,
  7. David Bigam2,
  8. Ray V. Rajotte3 and
  9. A.M. James Shapiro2
  1. 1Department of Medicine, Clinical Islet Transplant Program, University of Alberta and Capital Health Authority, Edmonton, Alberta, Canada
  2. 2Department of Surgery, Clinical Islet Transplant Program, University of Alberta and Capital Health Authority, Edmonton, Alberta, Canada
  3. 3Surgical Medical Research Institute, Clinical Islet Transplant Program, University of Alberta and Capital Health Authority, Edmonton, Alberta, Canada
  4. 4Capital Health Authority, Edmonton, Alberta, Canada
    Diabetes 2002 Jul; 51(7): 2148-2157. https://doi.org/10.2337/diabetes.51.7.2148
    PreviousNext
    • Article
    • Figures & Tables
    • Info & Metrics
    • PDF
    Loading

    Article Figures & Tables

    Figures

    • Tables
    • FIG. 1.
      • Download figure
      • Open in new tab
      • Download powerpoint
      FIG. 1.

      A: HbA1c at 3-month intervals after islet transplantation in subjects who remained insulin independent (n = 11). Each line represents an individual subject. B: Plasma glucose levels derived from standard meal tolerance tests in control subjects (n = 10) and patients before and after islet transplantation who have remained insulin independent (n = 11). Values are means ± SE. C: Plasma C-peptide levels derived from standard meal tolerance tests in control subjects (n = 10) and patients before and after islet transplantation who have remained insulin independent (n = 11). Values are means ± SE. Levels pretransplant were below detectability of the assay.

    • FIG. 2.
      • Download figure
      • Open in new tab
      • Download powerpoint
      FIG. 2.

      Fasting plasma C-peptide levels during the first 4 weeks (top panel) and at 3-month intervals for the full duration of follow-up (lower panel) in the 11 patients who remained insulin independent. Shown also are the values pretransplant (pre-Tx) and after the first transplant (mid). Values are means ± SE.

    • FIG. 3.
      • Download figure
      • Open in new tab
      • Download powerpoint
      FIG. 3.

      Exogenous insulin use (units/kg) in relation to the number of islets transplanted (IE/kg). Values for pretransplant (•), after first transplant (□), after second transplant (⧫), and after the third procedure (○) are shown. All patients became insulin independent once adequate islet numbers were provided.

    • FIG. 4.
      • Download figure
      • Open in new tab
      • Download powerpoint
      FIG. 4.

      AIRg (A) and AUCi (B) over time in insulin-independent subjects (n = 11) before and after islet transplantation as derived from the IVGTT. The number of subjects studied is shown across the top of the figure. Mean values ± SE are provided for each time point. Values for all time periods up to 24 months are significantly different from those of control subjects.

    • FIG. 5.
      • Download figure
      • Open in new tab
      • Download powerpoint
      FIG. 5.

      A: Relationship of the number of islets transplanted and AIRarg as derived from intravenous arginine infusion test at midtransplant (n = 6) and 3 months (n = 3) after transplant. B: Relationship of AUCi and the number of islets transplanted as derived from IVGTT at midtransplant (n = 13) and 3 months (n = 13) after transplant.

    • FIG. 6.
      • Download figure
      • Open in new tab
      • Download powerpoint
      FIG. 6.

      A: Relationship of AIRg as derived from IVGTT and fasting plasma glucose in subjects after islet transplant who were not taking exogenous insulin. B: Relationship of AIRg as derived from IVGTT and 2-h plasma glucose during the OGTT in subjects after islet transplant who were not taking exogenous insulin.

    Tables

    • Figures
    • TABLE 1

      Measures of insulin secretion after the first and final transplant

      After first transplantAfter final transplant
      IE infused374,283 ± 20,247850,035 ± 37,911
      AIRg (% of control)2 ± 121 ± 5
      AIRarg (% of control)17 ± 356 ± 11
      AUCi (% of control)10 ± 434 ± 5
      • Data are means ± SE based on the 17 subjects (for IE infused) who completed the Edmonton protocol; n = 13 for the glucose studies (both after first and final transplant) and n = 6 after first transplant and n = 8 after final transplant for the arginine studies. Nondiabetic subjects are reported as having 1.0–1.7 × 106 islets (23,24).

    • TABLE 2

      Relationship of both IE transplanted and the cold ischemic index with measures of insulin secretion and glucose disposal

      nrP
      Islet equivalents versus
       AIRg260.4630.017
       AIRarg90.7890.011
       AUCi260.5010.009
       AUCC-p260.5220.006
       KG260.4900.011
      Cold ischemia index versus
       AIRg260.5890.002
       AIRarg90.8270.006
       AUCi260.684<0.001
       AUCC-p260.728<0.001
       KG260.684<0.001
      • The cold ischemia index is based on the cold ischemia time and the number of islets transplanted (4). The measures of insulin secretion are AIRg, μU/ml; AIRarg, μU/ml; AUCi, μU · ml−1 · min−1; and AUCC-p, nmol · l−1 · min−1.

    • TABLE 3

      Relationship of glycemia (fasting plasma glucose and the 2-h glucose during the OGTT) with measures of insulin secretion and glucose disposal

      nrP
      Fasting plasma glucose versus
       AIRg61−0.485<0.001
       AIRarg14−0.0750.8
       AUCi61−0.422<0.001
       AUCC-p61−0.434<0.001
       KG61−0.350.006
      2-h Glucose post-OGTT versus
       AIRg28−0.748<0.001
       AIRarg4−0.80.2
       AUCi28−0.74<0.001
       AUCC-p28−0.69<0.001
       KG28−0.4740.011
      • Measure of insulin secretion and glucose disposal are as in Table 2.

    PreviousNext
    Back to top

    In this Issue

    July 2002, 51(7)
    • Table of Contents
    • Index by Author
    Sign up to receive current issue alerts
    View Selected Citations (0)
    Print
    Download PDF
    Article Alerts
    Sign In to Email Alerts with your Email Address
    Email Article

    Thank you for your interest in spreading the word about Diabetes.

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    Successful Islet Transplantation
    (Your Name) has forwarded a page to you from Diabetes
    (Your Name) thought you would like to see this page from the Diabetes web site.
    CAPTCHA
    This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
    Citation Tools
    Successful Islet Transplantation
    Edmond A. Ryan, Jonathan R.T. Lakey, Breay W. Paty, Sharleen Imes, Gregory S. Korbutt, Norman M. Kneteman, David Bigam, Ray V. Rajotte, A.M. James Shapiro
    Diabetes Jul 2002, 51 (7) 2148-2157; DOI: 10.2337/diabetes.51.7.2148

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero
    Add to Selected Citations
    Share

    Successful Islet Transplantation
    Edmond A. Ryan, Jonathan R.T. Lakey, Breay W. Paty, Sharleen Imes, Gregory S. Korbutt, Norman M. Kneteman, David Bigam, Ray V. Rajotte, A.M. James Shapiro
    Diabetes Jul 2002, 51 (7) 2148-2157; DOI: 10.2337/diabetes.51.7.2148
    del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
    • Tweet Widget
    • Facebook Like
    • Google Plus One

    Jump to section

    • Article
      • Abstract
      • RESEARCH DESIGN AND METHODS
      • RESULTS
      • DISCUSSION
      • Acknowledgments
      • Footnotes
      • REFERENCES
    • Figures & Tables
    • Info & Metrics
    • PDF

    Related Articles

    Cited By...

    More in this TOC Section

    • Glucagon Resistance and Decreased Susceptibility to Diabetes in a Model of Chronic Hyperglucagonemia
    • Acyl-Ghrelin Influences Pancreatic β-Cell Function by Interference with KATP Channels
    • Pancreatic β-Cell–Specific Deletion of VPS41 Causes Diabetes Due to Defects in Insulin Secretion
    Show more Islet Studies

    Similar Articles

    Navigate

    • Current Issue
    • Online Ahead of Print
    • Scientific Sessions Abstracts
    • Collections
    • Archives
    • Submit
    • Subscribe
    • Email Alerts
    • RSS Feeds

    More Information

    • About the Journal
    • Instructions for Authors
    • Journal Policies
    • Reprints and Permissions
    • Advertising
    • Privacy Policy: ADA Journals
    • Copyright Notice/Public Access Policy
    • Contact Us

    Other ADA Resources

    • Diabetes Care
    • Clinical Diabetes
    • Diabetes Spectrum
    • Scientific Sessions Abstracts
    • Standards of Medical Care in Diabetes
    • BMJ Open - Diabetes Research & Care
    • Professional Books
    • Diabetes Forecast

     

    • DiabetesJournals.org
    • Diabetes Core Update
    • ADA's DiabetesPro
    • ADA Member Directory
    • Diabetes.org

    © 2021 by the American Diabetes Association. Diabetes Print ISSN: 0012-1797, Online ISSN: 1939-327X.