Improved second phase insulin secretion and preserved insulin sensitivity after islet transplantation.

摘要

Islet transplantation is an effective therapy in type 1 diabetes complicated by debilitating hypoglycemia (1). Insulin secretion is a sensitive measure of islet graft function, and measures of insulin resistance may indicate potentially deleterious metabolic stress on islets. How best to monitor insulin secretion, insulin sensitivity (Si), and islet function posttransplantation, has yet to be definitively established. Second phase insulin secretion has not been documented in patients off insulin after an islet transplant, and only five studies have estimated Si after islet transplant, with variable results (2-6). There have been no published euglycemic-clamp studies in islet recipients taking modern immunosuppression, and only one study reports using a 180-min insulin-modified frequently sampled intravenous glucose tolerance test (FSIGT) (2).