Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 29 P698

ICEECE2012 Poster Presentations Diabetes (248 abstracts)

Relation between glucose daily profile (CGMS) and graft function after islet transplantation for type 1 diabetes mellitus

M. Vantyghem , V. Raverdy , A. Balavoine , F. Defrance , R. Caiazzo , J. Kerr-Conte , M. Hazzan & F. Pattou


Lille University Hospital, Lille, France.


Context: The influence of beta cell replacement on daily glucose profile in Type 1 diabetes mellitus (T1DM) is not firmly established.

Objective: To examine the influence of islet transplantation (IT) on the various component of dysglycemia in T1DM patients.

Design, setting and patients: Single arm open labeled study. Twenty-three consecutive patients with T1DM, 11 males and 12 females, 14 non uremic and 9 uremic with a previous kidney graft, receiving IT at a referral center from 2003 to 2007. All participants completed a 3-year follow-up.

Intervention: IT consisting of 2 or 3 intra-portal allogenic islet infusions over 3 months with the Edmonton immuno-suppression protocol.

Outcomes: Glucose daily profile was assessed during 72 hours by continuous glucose monitoring system (CGMS) prior to transplantation, at 6 months and yearly during 3 years after transplantation. Outcomes were mean glucose (MG), glucose standard deviation (GSD), the percentage of time spent in hyperglycemia >180 mg/dL (HYPER), and the percentage of time spent in hypoglycemia < 54 mg/dL (HYPO). Graft function was estimated with beta score, a previously validated index (range 0–8) based on insulin or oral treatment requirements, plasma C-peptide, blood glucose, and A1C. Analysis was per intention to treat.

Results: At 3 years, 19 patients had a functional graft and 10 remained insulin independent with A1c ≤6.5%. Median A1c in the whole cohort was 6.7% (interquartile range[IQR], 5.9%-7.7%) vs. 8.3% (IQR, 7.3%-9.0%) at baseline (P<0.01). The four CGMS outcomes were significantly improved vs. baseline (P<0.01), in a close relation with graft function (P<0.001). Partial function (beta score 3) was sufficient to abrogate HYPO but optimal function (beta score 8) was necessary to normalize MG, SD, and HYPER.

Conclusion: Glucose daily profile significantly improved during the 3-year period post-IT and reached normal values when optimal graft function was achieved.

Relation between graft function and the various outcomes of continuous glucose measurement during follow-up (a, mean glucose; b, glucose standard deviation; c, percentage of time with glucose >180 mg/dL; d, percentage of time with glucose <54 mg/dL). Tukey box plots indicates median interquartile range and upper and lower range. (P<0.0001; test for linear trend).

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.

/media/12551/413834g1.gif

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.