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Donor insulin use predicts beta-cell function after islet transplantation

Lookup NU author(s): Professor James Shaw

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Abstract

© 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.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.


Publication metadata

Author(s): Shapey IM, Summers A, Yiannoullou P, Khambalia H, Fullwood C, Hanley NA, Casey J, Forbes S, Rosenthal M, Johnson PRV, Choudhary P, Bushnell J, Shaw JAM, Augustine T, Rutter MK, van Dellen D

Publication type: Article

Publication status: Published

Journal: Diabetes, Obesity and Metabolism

Year: 2020

Pages: epub ahead of print

Online publication date: 25/05/2020

Acceptance date: 10/05/2020

ISSN (print): 1462-8902

ISSN (electronic): 1463-1326

Publisher: Blackwell Publishing Ltd

URL: https://doi.org/10.1111/dom.14088

DOI: 10.1111/dom.14088

PubMed id: 32452110


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