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Introduction: The 10-year survival rate is 100%, and the 20-year survival rate is more than 80%.
Patients with type 1 diabetes (T1D) are usually at risk of premature death due to complications related to acute and chronic diabetes.
Among them, severe hypoglycemia events (SHEs) and impaired perception of hypoglycemia are important factors leading to increased morbidity and mortality.
Islet transplantation (ITx) technology has been proven to normalize blood glucose control in T1D patients, restore hypoglycemia perception, prevent SHEs, and improve the quality of life.
However, there is relatively little research evidence regarding the impact of ITx on the long-term survival rate of patients.
Recently, Diabetes Care magazine published a related study that studied the 10-year and 20-year survival rates of patients treated with ITx.
Study description This is a retrospective study that included 49 T1D subjects who underwent ITx and followed up from 2000 to 2020.
Most subjects received percutaneous transhepatic portal vein puncture ITx treatment (n=46), and a small number of subjects received ITx treatment (n=3) in which islet cells were injected into the portal vein through the omental vein.
Main inclusion criteria: 18-65 years old, T1D course of> 5 years, impaired perception of hypoglycemia, significant blood glucose fluctuations, and a history of SHE in the 12 months before enrollment.
The endpoint of the study was death (reported by family members).
A total of 29 women (59.
2%) and 20 men (40.
8%) were included.
The total follow-up was 610.
1 person-years, and the median time after ITx was 13.
8 years.
At the time of T1D diagnosis, the median age of the participants was 13.
2 years. The average age at the time of ITx was 42.
8 years, and the average duration of diabetes was 29.
5 years.
During the period of immunosuppression, the median duration of graft function was 4.
4 years.
During the follow-up period, 31.
3% of subjects underwent functional tests of allograft (n=15).
When receiving ITx treatment, 86% of patients had no proteinuria, 12% had microalbuminuria, and 2% had massive proteinuria.
The 10-year cumulative survival rate is 100%, and the 20-year survival rate is more than 80%.
Kaplan-Meier survival analysis shows that the cumulative survival rate of 10 years and 20 years after ITx is 100% and more than 80%, respectively, and the mortality rate is 3.
28/1000.
Years (Figure 1).
Figure 1 The results of the study compare the mortality of T1D patients at similar ages and periods.
ITx is better.
The Pittsburgh Epidemiological Study of Diabetes Complications (EDC) observes that the mortality rate of T1D patients is 10.
79/1000 person-years (diagnosed between 1950 and 1980) And 5.
31/1000 person-years (66.
9% were diagnosed between 1965-1980); The Allegheny Type 1 Diabetes Study (ACR) had a related mortality rate of 7.
99/1000 person-years (diagnosed between 1965-1979).
Among them, the cumulative survival rate of subjects in the same age group as reported in this study (MIA) in the EDC study was 59% within 20 years, and it was >80% in this study.
However, the researchers pointed out that considering that the inclusion criteria of this study are stricter (for example, most patients are not associated with proteinuria), it may bring bias.
Summary of this article The results of this study indicate that there is no correlation between ITx and increased mortality regardless of whether or not they receive long-term immunosuppressive therapy.
ITx can achieve near-normal blood sugar control and eliminate SHEs, while improving the quality of life of patients.
Yimaitong compiled and compiled from: Joana RNLemos, David A.
Baidal, Camillo Ricordi, et al.
Diabetes Care.
2021 Apr; 44 (4): e67-e68.
https://doi.
org/10.
2337/dc20-2458.
Introduction: The 10-year survival rate is 100%, and the 20-year survival rate is more than 80%.
Patients with type 1 diabetes (T1D) are usually at risk of premature death due to complications related to acute and chronic diabetes.
Among them, severe hypoglycemia events (SHEs) and impaired perception of hypoglycemia are important factors leading to increased morbidity and mortality.
Islet transplantation (ITx) technology has been proven to normalize blood glucose control in T1D patients, restore hypoglycemia perception, prevent SHEs, and improve the quality of life.
However, there is relatively little research evidence regarding the impact of ITx on the long-term survival rate of patients.
Recently, Diabetes Care magazine published a related study that studied the 10-year and 20-year survival rates of patients treated with ITx.
Study description This is a retrospective study that included 49 T1D subjects who underwent ITx and followed up from 2000 to 2020.
Most subjects received percutaneous transhepatic portal vein puncture ITx treatment (n=46), and a small number of subjects received ITx treatment (n=3) in which islet cells were injected into the portal vein through the omental vein.
Main inclusion criteria: 18-65 years old, T1D course of> 5 years, impaired perception of hypoglycemia, significant blood glucose fluctuations, and a history of SHE in the 12 months before enrollment.
The endpoint of the study was death (reported by family members).
A total of 29 women (59.
2%) and 20 men (40.
8%) were included.
The total follow-up was 610.
1 person-years, and the median time after ITx was 13.
8 years.
At the time of T1D diagnosis, the median age of the participants was 13.
2 years. The average age at the time of ITx was 42.
8 years, and the average duration of diabetes was 29.
5 years.
During the period of immunosuppression, the median duration of graft function was 4.
4 years.
During the follow-up period, 31.
3% of subjects underwent functional tests of allograft (n=15).
When receiving ITx treatment, 86% of patients had no proteinuria, 12% had microalbuminuria, and 2% had massive proteinuria.
The 10-year cumulative survival rate is 100%, and the 20-year survival rate is more than 80%.
Kaplan-Meier survival analysis shows that the cumulative survival rate of 10 years and 20 years after ITx is 100% and more than 80%, respectively, and the mortality rate is 3.
28/1000.
Years (Figure 1).
Figure 1 The results of the study compare the mortality of T1D patients at similar ages and periods.
ITx is better.
The Pittsburgh Epidemiological Study of Diabetes Complications (EDC) observes that the mortality rate of T1D patients is 10.
79/1000 person-years (diagnosed between 1950 and 1980) And 5.
31/1000 person-years (66.
9% were diagnosed between 1965-1980); The Allegheny Type 1 Diabetes Study (ACR) had a related mortality rate of 7.
99/1000 person-years (diagnosed between 1965-1979).
Among them, the cumulative survival rate of subjects in the same age group as reported in this study (MIA) in the EDC study was 59% within 20 years, and it was >80% in this study.
However, the researchers pointed out that considering that the inclusion criteria of this study are stricter (for example, most patients are not associated with proteinuria), it may bring bias.
Summary of this article The results of this study indicate that there is no correlation between ITx and increased mortality regardless of whether or not they receive long-term immunosuppressive therapy.
ITx can achieve near-normal blood sugar control and eliminate SHEs, while improving the quality of life of patients.
Yimaitong compiled and compiled from: Joana RNLemos, David A.
Baidal, Camillo Ricordi, et al.
Diabetes Care.
2021 Apr; 44 (4): e67-e68.
https://doi.
org/10.
2337/dc20-2458.
