Management of Hypoglycemic Unawareness and the Current Status of Clinical Allogeneic Islet Transplantation / 임상당뇨병
Journal of Korean Diabetes
;
: 6-10, 2016.
Artigo
em Coreano
| 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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Peptídeo C
/
Prevalência
/
Estudos de Coortes
/
Transplante das Ilhotas Pancreáticas
/
Transplante de Pâncreas
/
Transplantes
/
Educação
/
Liberdade
/
Glucose
/
Hipoglicemia
Tipo de estudo:
Estudo de etiologia
/
Guia de Prática Clínica
/
Estudo de incidência
/
Estudo observacional
/
Estudo de prevalência
/
Fatores de risco
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Coreano
Revista:
Journal of Korean Diabetes
Ano de publicação:
2016
Tipo de documento:
Artigo
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