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Donor insulin use predicts beta-cell function after islet transplantation

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journal contribution
posted on 09.09.2021, 09:39 by IM Shapey, A Summers, P Yiannoullou, H Khambalia, C Fullwood, NA Hanley, J Casey, S Forbes, M Rosenthal, PRV Johnson, P Choudhary, J Bushnell, JAM Shaw, T Augustine, MK Rutter, D van Dellen
Insulin is routinely used to manage hyperglycaemia in organ donors and during the peri-transplant period in islet transplant recipients. However, it is unknown whether donor insulin use (DIU) predicts beta-cell dysfunction after islet transplantation. We reviewed data from the UK Transplant Registry and the UK Islet Transplant Consortium; all first-time transplants during 2008-2016 were included. Linear regression models determined associations between DIU, median and coefficient of variation (CV) peri-transplant glucose levels and 3-month islet graft function. In 91 islet cell transplant recipients, DIU was associated with lower islet function assessed by BETA-2 scores (β [SE] -3.5 [1.5], P = .02), higher 3-month post-transplant HbA1c levels (5.4 [2.6] mmol/mol, P = .04) and lower fasting C-peptide levels (−107.9 [46.1] pmol/l, P = .02). Glucose at 10 512 time points was recorded during the first 5 days peri-transplant: the median (IQR) daily glucose level was 7.9 (7.0-8.9) mmol/L and glucose CV was 28% (21%-35%). Neither median glucose levels nor glucose CV predicted outcomes post-transplantation. Data on DIU predicts beta-cell dysfunction 3 months after islet transplantation and could help improve donor selection and transplant outcomes.

Funding

This study was funded by the Medical Research Council, the Royal College of Surgeons of Edinburgh and Diabetes UK.

History

Citation

Diabetes, Obesity and Metabolism, Volume 22, Issue 10, October 2020, Pages 1874-1879

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

VoR (Version of Record)

Published in

Diabetes, Obesity and Metabolism

Volume

22

Issue

10

Pagination

1874 - 1879

Publisher

Wiley

issn

1462-8902

eissn

1463-1326

Acceptance date

10/05/2020

Copyright date

2020

Available date

09/09/2021

Spatial coverage

England

Language

eng

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