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

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/electron microscopy 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.

• Authors: 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
• Journal: Diabetes care (Diabetes Care) Vol. 37 Issue 1 Pg. 267-76 ( 2014) ISSN: 1935-5548 [Electronic] United States
• PMID: 24026546 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Immunosuppressive Agents

Topics

• Adult
• Blood Glucose (metabolism)
• Blood Platelets (pathology, physiology)
• Brain (metabolism, pathology, physiopathology)
• Diabetes Mellitus, Type 1 (pathology, physiopathology, psychology, surgery)
• Female
• Hemostasis
• Humans
• Immunosuppressive Agents (therapeutic use)
• Islets of Langerhans Transplantation
• Male
• Pilot Projects
• Quality of Life
• Retrospective Studies