BACKGROUND: Body fat accumulation decreases insulin sensitivity. It has being associated with earlier onset of type 1 diabetes mellitus (DM) and islet graft failure. The aim of this study was to evaluate whether insulin resistance, characterized by risk factors for type 2 DM, can predict islet graft survival in type 1 DM islet transplant (ITx) recipients. METHODS: Demographic, anthropometrical, and laboratory data, as well as family history of type 2 DM (first degree relatives), were collected from 44 ITx recipients. Risk factors for type 2 DM, such as positive family history of type 2 DM (n=11) and overweight (body mass index >25 kg/m2; n=14), were analyzed separately and in combination, which was designated as "type 2 DM phenotype" (n=5). Differences in outcomes (time-to-graft dysfunction and failure) were compared using Kaplan-Meier curves. Cox regression analysis was performed to control for possible confounding factors. RESULTS: Neither positive family history of type 2 DM nor overweight at baseline could predict islet function outcomes after ITx. However, when both risk factors were grouped, the "type 2 DM phenotype" was associated with earlier islet graft failure (mean estimate graft survival 25.7+/-9.1 vs. 54.1+/-5.2 months, P=0.022). These results were sustained after adjustments for confounding variables (OR 5.20, 95% CI 1.12-24.0). CONCLUSIONS: Predisposition for type 2 DM can coexist with the type 1 DM phenotype and is associated with earlier decline in islet graft function. Prospective clinical trials should address whether it is associated with decreased insulin sensitivity and if insulin sensitizers play a role in prolonging islet graft survival.
BACKGROUND: Body fat accumulation decreases insulin sensitivity. It has being associated with earlier onset of type 1 diabetes mellitus (DM) and islet graft failure. The aim of this study was to evaluate whether insulin resistance, characterized by risk factors for type 2 DM, can predict islet graft survival in type 1 DM islet transplant (ITx) recipients. METHODS: Demographic, anthropometrical, and laboratory data, as well as family history of type 2 DM (first degree relatives), were collected from 44 ITx recipients. Risk factors for type 2 DM, such as positive family history of type 2 DM (n=11) and overweight (body mass index >25 kg/m2; n=14), were analyzed separately and in combination, which was designated as "type 2 DM phenotype" (n=5). Differences in outcomes (time-to-graft dysfunction and failure) were compared using Kaplan-Meier curves. Cox regression analysis was performed to control for possible confounding factors. RESULTS: Neither positive family history of type 2 DM nor overweight at baseline could predict islet function outcomes after ITx. However, when both risk factors were grouped, the "type 2 DM phenotype" was associated with earlier islet graft failure (mean estimate graft survival 25.7+/-9.1 vs. 54.1+/-5.2 months, P=0.022). These results were sustained after adjustments for confounding variables (OR 5.20, 95% CI 1.12-24.0). CONCLUSIONS: Predisposition for type 2 DM can coexist with the type 1 DM phenotype and is associated with earlier decline in islet graft function. Prospective clinical trials should address whether it is associated with decreased insulin sensitivity and if insulin sensitizers play a role in prolonging islet graft survival.
Authors: Bernhard J Hering; Raja Kandaswamy; Jeffrey D Ansite; Peter M Eckman; Masahiko Nakano; Toshiya Sawada; Ippei Matsumoto; Sung-Hee Ihm; Hui-Jian Zhang; Jamen Parkey; David W Hunter; David E R Sutherland Journal: JAMA Date: 2005-02-16 Impact factor: 56.272
Authors: Leslie O Schulz; Peter H Bennett; Eric Ravussin; Judith R Kidd; Kenneth K Kidd; Julian Esparza; Mauro E Valencia Journal: Diabetes Care Date: 2006-08 Impact factor: 19.112
Authors: Tatiana Froud; Camillo Ricordi; David A Baidal; Muhammad M Hafiz; Gaston Ponte; Pablo Cure; Antonello Pileggi; Raffaella Poggioli; Hirohito Ichii; Aisha Khan; Jacqueline V Ferreira; Alberto Pugliese; Violet V Esquenazi; Norma S Kenyon; Rodolfo Alejandro Journal: Am J Transplant Date: 2005-08 Impact factor: 8.086
Authors: A M Shapiro; J R Lakey; E A Ryan; G S Korbutt; E Toth; G L Warnock; N M Kneteman; R V Rajotte Journal: N Engl J Med Date: 2000-07-27 Impact factor: 91.245
Authors: Dana Dabelea; Ralph B D'Agostino; Elizabeth J Mayer-Davis; David J Pettitt; Giuseppina Imperatore; Larry M Dolan; Catherine Pihoker; Teresa A Hillier; Santica M Marcovina; Barbara Linder; Andrea M Ruggiero; Richard F Hamman Journal: Diabetes Care Date: 2006-02 Impact factor: 19.112
Authors: Edmond A Ryan; Breay W Paty; Peter A Senior; David Bigam; Eman Alfadhli; Norman M Kneteman; Jonathan R T Lakey; A M James Shapiro Journal: Diabetes Date: 2005-07 Impact factor: 9.461
Authors: Ravi Bhargava; Peter A Senior; Thomas E Ackerman; Edmond A Ryan; Breay W Paty; Jonathan R T Lakey; A M James Shapiro Journal: Diabetes Date: 2004-05 Impact factor: 9.461
Authors: Else M Balke; Simke Demeester; DaHae Lee; Pieter Gillard; Robert Hilbrands; Ursule Van de Velde; Bart J Van der Auwera; Zhidong Ling; Bart O Roep; Daniël G Pipeleers; Bart Keymeulen; Frans K Gorus Journal: Diabetologia Date: 2018-04-20 Impact factor: 10.122