Donor insulin use predicts beta‐cell function after islet transplantation

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Angela Summers
  • Petros Yiannoullou
  • Hussein Khambalia
  • Catherine Fullwood
  • John Casey
  • Shareen Forbes
  • Miranda Rosenthal
  • Prv Johnson
  • P Choudhary
  • James Bushnell
  • James Am Shaw
  • D Van Dellen

Abstract

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 United Kingdom (UK) Transplant Registry and the UK Islet Transplant Consortium – all first‐time transplants between 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 = 0.02), higher 3‐month post‐transplant HbA1c levels (5.4 [2.6] mmol/mol, p = 0.04) and lower fasting c‐peptide levels (−107.9 [46.1] pmol/l, p = 0.02). Glucose at 10512 time points were 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: 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.

Bibliographical metadata

Original languageEnglish
JournalDiabetes, Obesity and Metabolism
Early online date25 May 2020
DOIs
Publication statusE-pub ahead of print - 25 May 2020