Management of Hypoglycemic Unawareness and the Current Status of Clinical Allogeneic Islet Transplantation / 임상당뇨병
Journal of Korean Diabetes
;
: 6-10, 2016.
Article
in Korean
| WPRIM
| ID: wpr-726843
ABSTRACT
Problematic hypoglycemia is defined as a condition in which episodes of severe hypoglycemia are unpredictable and/or cannot be easily explained or prevented, typically associated with impaired awareness of hypoglycemia. The treatment algorithm for patients with type 1 diabetes and problematic hypoglycemia emphasizes the stepwise approach including structured education regarding multiple daily injections of insulin, use of technology such as sensor-augmented pump with low glucose suspension, and islet or pancreas transplantation. Although the prevalence of insulin independence at 5 years is 25~50% in most recent clinical trials of islet transplantation, both islet and pancreas transplantation are equally efficient to cure severe hypoglycemia for more than 5 years in about 70% of the recipients. To date, international cohorts of clinical islet transplantation such as the French-Swiss GRAGIL Network have successfully reproduced the long-term C-peptide positivity initially achieved with the Edmonton protocol, with long-term insulin independence demonstrated in selected cases. Several cases with partial islet graft function have been reported in Korea, with the first case of long-term insulin independence being reported in late 2015. Therefore, islet transplantation can offer freedom from life-threatening severe hypoglycemia for type 1 diabetes patients with problematic hypoglycemia, even in non-responders to the latest technology-based treatment.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
C-Peptide
/
Prevalence
/
Cohort Studies
/
Islets of Langerhans Transplantation
/
Pancreas Transplantation
/
Transplants
/
Education
/
Freedom
/
Glucose
/
Hypoglycemia
Type of study:
Etiology study
/
Practice guideline
/
Incidence study
/
Observational study
/
Prevalence study
/
Risk factors
Limits:
Humans
Country/Region as subject:
Asia
Language:
Korean
Journal:
Journal of Korean Diabetes
Year:
2016
Type:
Article
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