Abstract | CONTEXT: OBJECTIVE: The objective of the study was to determine whether the avoidance of hypoglycemia achieved through islet transplantation results in improved glycemic thresholds for counterregulatory responses. SETTING: The study was conducted at a general clinical research center. PARTICIPANTS: Seven islet transplant recipients, six type 1 diabetic, and eight nondiabetic control subjects participated in the study. INTERVENTION: We performed a stepped hyperinsulinemic hypoglycemic clamp and, in 12 subjects, a paired hyperinsulinemic euglycemic clamp to calculate the glycemic thresholds for and magnitude of counterregulatory responses. RESULTS: The glycemic thresholds for all counterregulatory hormone and symptom responses in the islet transplant group were comparable with normal and higher than in the type 1 diabetes group (P < 0.01 for glucagon; P < 0.05 for epinephrine). The magnitude of the glucagon and epinephrine responses in the islet transplant group, although greater than in the type 1 diabetes group (P < 0.05 for both), remained less than normal (P < 0.01 for glucagon; P < 0.05 for epinephrine). The magnitude of GH secretion in the islet transplant group was comparable with normal and greater than in the type 1 diabetes group (P < 0.05). CONCLUSIONS:
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Authors | Michael R Rickels, Mark H Schutta, Rebecca Mueller, Shiv Kapoor, James F Markmann, Ali Naji, Karen L Teff |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 92
Issue 3
Pg. 873-9
(Mar 2007)
ISSN: 0021-972X [Print] United States |
PMID | 17192287
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Blood Glucose
- Insulin
- Human Growth Hormone
- Glucagon
- Epinephrine
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Topics |
- Adult
- Blood Glucose
(physiology)
- Diabetes Mellitus, Type 1
(blood, therapy)
- Epinephrine
(blood)
- Female
- Glucagon
(blood)
- Glucose Clamp Technique
- Human Growth Hormone
(blood)
- Humans
- Hypoglycemia
(blood)
- Insulin
(blood)
- Islets of Langerhans Transplantation
- Male
- Middle Aged
- Transplantation
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