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Donor insulin use predicts beta‐cell function after islet transplantation
Author(s) -
Shapey Iestyn M.,
Summers Angela,
Yiannoullou Petros,
Khambalia Hussein,
Fullwood Catherine,
Hanley Neil A.,
Casey John,
Forbes Shareen,
Rosenthal Miranda,
Johnson Paul RV,
Choudhary Pratik,
Bushnell James,
Shaw James A. M.,
Augustine Titus,
Rutter Martin K.,
Dellen David
Publication year - 2020
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14088
Subject(s) - islet , transplantation , medicine , insulin , diabetes mellitus , endocrinology , beta cell , islet cell transplantation
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.