The Second Phase of Insulin Secretion in Nondiabetic Islet-Grafted Recipients Is Altered and Can Predict Graft Outcome

Details

Serval ID
serval:BIB_BBC5A476A059
Type
Article: article from journal or magazin.
Collection
Publications
Title
The Second Phase of Insulin Secretion in Nondiabetic Islet-Grafted Recipients Is Altered and Can Predict Graft Outcome
Journal
J Clin Endocrinol Metab
Author(s)
Villard O., Brun J. F., Bories L., Molinari N., Benhamou P. Y., Berney T., Wojtusciszyn A.
ISSN
1945-7197 (Electronic)
ISSN-L
0021-972X
Publication state
Published
Issued date
2018
Volume
103
Number
4
Pages
1310-1319
Language
english
Notes
Villard, Orianne
Brun, Jean Frederic
Bories, Lisa
Molinari, Nicolas
Benhamou, Pierre Yves
Berney, Thierry
Wojtusciszyn, Anne
eng
J Clin Endocrinol Metab. 2018 Apr 1;103(4):1310-1319. doi: 10.1210/jc.2017-01342.
Abstract
Context: Islet transplantation (IT) can treat patients with severely unstable type 1 diabetes. Prehepatic kinetics of insulin secretion (ISec) in two phases can be calculated by C-peptide levels during meal tests. We proposed to describe the ISec profile after a mixed-meal tolerance test (MMTT) in IT recipients and to determine whether the calculated ISec indexes can predict graft outcome. Methods: We analyzed 34 MMTT among 11 patients who underwent IT between 2011 and 2016 and compared them with healthy controls and patients with type 2 diabetes (T2D). ISec indexes and insulin sensitivity were calculated from models of Van Cauter, Breda, and Mari after MMTT. Graft success was defined by total insulin independence without any criteria for diabetes. Results: In patients with successful IT, the first- and second-phase ISec indexes were lower than those of controls (P < 0.001) and did not differ from those of the T2D group. Nevertheless, insulin sensitivity of IT recipients was similar to that of the control group and higher than that of the T2D group. The index of the second phase of ISec S was correlated with total infused islet equivalents (IEQs), was a good predictor of diabetes (re)occurrence, and allowed us to calculate 9500 IEQ/kg as the minimum needed to reach insulin independence. Conclusion: We showed that indexes from the first and second phases of ISec are altered in insulin-independent IT recipients. Higher sensitivity distinguishes them from patients with T2D. Even in insulin-independent patients, IT remains a marginal mass model. Moreover, S can estimate transplanted islet mass and predict IT recipient outcomes.
Keywords
Adult, Blood Glucose/metabolism, Case-Control Studies, Diabetes Mellitus, Type 1/blood/*surgery, Diabetes Mellitus, Type 2/blood, Diagnostic Techniques, Endocrine, Female, Humans, Insulin/blood/*metabolism, Insulin Secretion, *Islets of Langerhans Transplantation, Male, Middle Aged, Postoperative Period, Prognosis, Treatment Outcome
Pubmed
Create date
14/06/2021 9:59
Last modification date
18/09/2021 6:38
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