Islet Transplantation Versus Standard of Care for Type 1 Diabetes Complicated by Severe Hypoglycemia From the Collaborative Islet Transplant Registry and the T1D Exchange Registry
Authors' conclusion
Islet transplantation for adults with type 1 diabetes complicated by SHEs results in near-normal glycemic control in the absence of SHEs more often than observed with standard of care, but at the cost of greater reduction in kidney function.
Study context
- Population
- Adults with T1D complicated by severe hypoglycemia events (seizure or loss of consciousness)
- Participants
- 71 vs 213
- Comparison
- Islet transplantation vs standard of care
- Collaborative Islet Transplant Registry (CITR)n = 71
- T1DXn = 213reference
- Outcome
- HbA1c <7.0% and absence of an SHE
- Follow-up
- Over 5 years
Methodological detailsregistry-based, 5-year follow-up
- Registry-based
- 5-year follow-up
Main finding
As reported in the abstract
CITR
71-80%
T1DX
21-33%
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | CITR | T1DX | P value |
|---|---|---|---|
| HbA1c ≤6.5% and absence of an SHE | 60-75% | 10-20% | P < 0.001 |
Insulin requirement
- Significantly less insulin required in CITR (majority insulin independent)
Safety
| Outcome | CITR | T1DX | P value |
|---|---|---|---|
| Change in eGFR from baseline · over 5 yearsGreater decline with CITR | −8.8 to −20 mL ⋅ min-1 ⋅ 1.73 m-2 | −1.3 to −6.5 mL ⋅ min-1 ⋅ 1.73 m-2 | P < 0.001 |
Original publication
Islet Transplantation Versus Standard of Care for Type 1 Diabetes Complicated by Severe Hypoglycemia From the Collaborative Islet Transplant Registry and the T1D Exchange Registry. Diabetes Care. Published 14 February 2025. doi:10.
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