Mechanisms of Glucose Counterregulation in Pancreatic Islet Transplantation

Metabolic Studies in Type 1 Diabetic Patients After Allogenic Intraportal Islet Transplantation.

Pancreatic islet transplantation improves glucose counterregulation and stabilizes glycemic control in patients with type 1 diabetes mellitus prone to severe hypoglycemia even if insulin independence is not achieved. However, the extent and underlying metabolic pathways of this improvement are unknown. Investigators therefore compare systemic glucose turnover including lactate gluconeogenesis and muscle glucose utilization, between insulin-requiring islet transplant recipients, matched type 1 diabetic subjects who did not receive islet transplantation, and matched healthy non-diabetic subjects.

Subjects (n=12 each group) undergo a hypoglycemic and a euglycemic hyperinsulinemic clamp in a randomized fashion. Systemic and skeletal muscle glucose and lactate kinetics are assessed using a combination of isotopic and forearm balance techniques.

T1DM/ITX+

Inclusion Criteria:

• Type 1 Diabetes
• Pancreatic islet transplantation

Exclusion Criteria:

• Type 2 Diabetes