Document Detail


Islet cell hormonal responses to hypoglycemia after human islet transplantation for type 1 diabetes.
MedLine Citation:
PMID:  16249446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Islet transplantation can eliminate severe hypoglycemic episodes in patients with type 1 diabetes; however, whether intrahepatic islets respond appropriately to hypoglycemia after transplantation has not been fully studied. We evaluated six islet transplant recipients, six type 1 diabetic subjects, and seven nondiabetic control subjects using a stepped hyperinsulinemic-hypoglycemic clamp. Also, three islet transplant recipients and the seven control subjects underwent a paired hyperinsulinemic-euglycemic clamp. In response to hypoglycemia, C-peptide was similarly suppressed in islet transplant recipients and control subjects and was not detectable in type 1 diabetic subjects. Glucagon was significantly more suppressed in type 1 diabetic subjects than in islet transplant recipients (P < 0.01), although the glucagon in islet transplant recipients failed to activate as in the control subjects (P < 0.01). Pancreatic polypeptide failed to activate in both type 1 diabetic subjects and islet transplant recipients compared with control subjects (P < 0.01). In islet transplant recipients, glucagon was suppressed normally by hyperinsulinemia during the euglycemic clamp and was significantly greater during the paired hypoglycemic clamp (P < 0.01). These results suggest that after islet transplantation and in response to insulin-induced hypoglycemia, endogenous insulin secretion is appropriately suppressed and glucagon secretion may be partially restored.
Authors:
Michael R Rickels; Mark H Schutta; Rebecca Mueller; James F Markmann; Clyde F Barker; Ali Naji; Karen L Teff
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes     Volume:  54     ISSN:  0012-1797     ISO Abbreviation:  Diabetes     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-26     Completed Date:  2006-01-20     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372763     Medline TA:  Diabetes     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3205-11     Citation Subset:  AIM; IM    
Affiliation:
Division of Endocrinology, Diabetes & Metabolism, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6149, USA. rickels@mail.med.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose
Case-Control Studies
Diabetes Mellitus, Type 1 / surgery*
Female
Glucagon / blood
Humans
Hypoglycemia / metabolism*
Insulin / blood
Islets of Langerhans / metabolism*
Islets of Langerhans Transplantation*
Male
Middle Aged
Grant Support
ID/Acronym/Agency:
K12-RR017625/RR/NCRR NIH HHS; M01-RR-00040/RR/NCRR NIH HHS; P30-DK-19525/DK/NIDDK NIH HHS; U42-RR-016600/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 11061-68-0/Insulin; 9007-92-5/Glucagon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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