Restoration of endogenous C-peptide by islet transplantation is associated with increased duration of normoglycaemia and reduced blood glucose variability in recipients with Type 1 Diabetes

Brooks, Augustin, Aldibbiat, A., Bennett, Denise, Wardle, Julie, Gordon, Charlotte, Walker, Mark and Shaw, Jim (2013) Restoration of endogenous C-peptide by islet transplantation is associated with increased duration of normoglycaemia and reduced blood glucose variability in recipients with Type 1 Diabetes. In: Diabetes UK Professional Conference 2013, 13th - 15th March 2013, Manchester, UK.

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Abstract

Aims: The Diabetes Control and Complications Trial reported that maintained C-peptide production benefits blood glucose control in individuals with Type 1 diabetes. We investigated whether restoration of endogenous C-peptide production by islet transplantation improved blood glucose control, and whether loss of C-peptide below a given threshold reduced clinical benefit.

Methods: Ten UK islet recipients [age (mean ± SD) 52.3 ± 6.8years, 90% female] had continuous glucose monitoring (CGM) for five to seven days pre-transplant and one, three and six months post-transplant. At each follow-up, graft function was determined by 90min C-peptide during a meal tolerance test (MTT90). Blood glucose <3mmol/l was considered hypoglycaemic and >10mmol/l hyperglycaemic. Blood glucose variability was assessed by standard deviation from mean glucose. Outcomes were compared in recipients with MTT90>200pmol/l vs<200pmol/l.

Results: Islet graft function with MTT90>200pmol/l was established in 80%, 80% and 70% of recipients at one, three and six months post-transplant respectively. Recipients achieving MTT90>200pmol/l spent more time normoglycaemic post-transplant (48.6% pre- vs 80.9%, 77.7%, 82.9% at one, three and six months post-transplant, p<0.01) and less time hyperglycaemic (42.8% pre- vs 16.2% six months post-transplant, p<0.03). Mean blood glucose variability was significantly reduced in individuals with MTT90>200pmol/l compared with pre-transplant (2.2mmol/l vs 4.1mmol/l, p<0.01) and individuals with MTT90<200pmol/l (4.0mmol/l, p<0.01), who failed to sustain significant improvement in variability compared with pre-transplant (p=0.86).

Conclusions: Stimulated C-peptide>200pmol/l was associated with reduced hyperglycaemia and blood glucose variability post-islet transplant. Therapies aimed at maintaining/restoring endogenous C-peptide production need to consider the thresholds required for clinical benefit.

Item Type:	Conference or Workshop Item (Poster)
Subjects:	A300 Clinical Medicine
Department:	Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User:	Paul Burns
Date Deposited:	07 May 2019 09:55
Last Modified:	10 Oct 2019 19:16
URI:	http://nrl.northumbria.ac.uk/id/eprint/39198

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