Defining outcomes for β-cell replacement therapy in the treatment of diabetes
| Autor: | Peter A. Senior, Marie-Christine Vantyghem, Lorenzo Piemonti, James Shaw, Esther Latres, Johann Pratschke, François Pattou, Eelco J.P. de Koning, Barbara Ludwig, Paul Johnson, Thierry Berney, Raja Kandaswamy, Rodolfo Alejandro, Roger Lehmann, James F. Markmann, Steven A. White, Thomas W.H. Kay, Robert M. Langer, Jon S. Odorico, Marjana Marinac, Michael R. Rickels, Bart Keymeulen, Peter G. Stock, Pratik Choudhary, Melena D. Bellin, Yogish C. Kudva |
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| Přispěvatelé: | Pathology/molecular and cellular medicine, Diabetes Pathology & Therapy, Diabetes Clinic, Rickels, Michael R, Stock, Peter G, de Koning, Eelco J P, Piemonti, Lorenzo, Pratschke, Johann, Alejandro, Rodolfo, Bellin, Melena D, Berney, Thierry, Choudhary, Pratik, Johnson, Paul R, Kandaswamy, Raja, Kay, Thomas W H, Keymeulen, Bart, Kudva, Yogish C, Latres, Esther, Langer, Robert M, Lehmann, Roger, Ludwig, Barbara, Markmann, James F, Marinac, Marjana, Odorico, Jon S, Pattou, Françoi, Senior, Peter A, Shaw, James A M, Vantyghem, Marie-Christine, White, Steven, Hubrecht Institute for Developmental Biology and Stem Cell Research |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
Glycated Hemoglobin A endocrine system diseases medicine.medical_treatment Islets of Langerhans Transplantation Review 030230 surgery chemistry.chemical_compound 0302 clinical medicine Insulin-Secreting Cells Outcome Assessment Health Care Diabetes Mellitus/blood Medicine risk factors Outcome geography.geographical_feature_category ddc:617 C-Peptide islet clinical Islet medicine.anatomical_structure Treatment Outcome C-Peptide/blood Pancreas medicine.medical_specialty Consensus Glycated Hemoglobin A/metabolism 030209 endocrinology & metabolism pancreas clinical Hypoglycemic Agents/therapeutic use Hypoglycemia Article 03 medical and health sciences Outcome Assessment (Health Care) Insulin-Secreting Cells/metabolism Internal medicine Diabetes mellitus Journal Article Diabetes Mellitus Hypoglycemic Agents Humans Glycemic Glycated Hemoglobin geography Blood Glucose/metabolism business.industry Insulin Islets of Langerhans Transplantation/adverse effects Consensus Development Conference medicine.disease Transplantation chemistry Etiology Hypoglycemia/blood Glycated hemoglobin business Biomarkers Biomarkers/blood transplantation |
| Zdroj: | Transplant International, 31(4), 343-352 Transplantation, 102(9), 1479-1486 Transplantation, 102(9), 1479-1486. Lippincott Williams & Wilkins Transplantation, Vol. 102, No 9 (2018) pp. 1479-1486 Transplant International, Vol. 31 (2018) pp. 343-352 Transplant International Transplant international : official journal of the European Society for Organ Transplantation, 31(4), 343-352. Wiley-Blackwell |
| ISSN: | 0934-0874 0041-1337 |
| DOI: | 10.1111/tri.13138 |
| Popis: | β-cell replacement therapy, available currently as pancreas or islet transplantation, has developed without a clear definition of graft functional and clinical outcomes. The International Pancreas and Islet Transplant Association and European Pancreas and Islet Transplantation Association held a workshop to develop consensus for an International Pancreas and Islet Transplant Association and European Pancreas and Islet Transplant Association Statement on the definition of function and failure of current and future forms of β-cell replacement therapy. There was consensus that β-cell replacement therapy could be considered as a treatment for β-cell failure, regardless of etiology and without requiring undetectable C-peptide, accompanied by glycemic instability with either problematic hypoglycemia or hyperglycemia. Glycemic control should be assessed at a minimum by glycated hemoglobin (HbA(1c)) and the occurrence of severe hypoglycemia. Optimal β-cell graft function is defined by near-normal glycemic control (HbA(1c) ≤6.5% [48 mmol/mol]) without severe hypoglycemia or requirement for insulin or other antihyperglycemic therapy, and with an increase over pretransplant measurement of C-peptide. Good β-cell graft function requires HbA(1c) less than 7.0% (53 mmol/mol) without severe hypoglycemia and with a significant (>50%) reduction in insulin requirements and restoration of clinically significant C-peptide production. Marginal β-cell graft function is defined by failure to achieve HbA(1c) less than 7.0% (53 mmol/mol), the occur-rence of any severe hypoglycemia, or less than 50% reduction in insulin requirements when there is restoration of clinically significant C-peptide production documented by improvement in hypoglycemia awareness/severity, or glycemic variability/lability. A failed β-cell graft is defined by the absence of any evidence for clinically significant C-peptide production. Optimal and good function are considered successful clinical outcomes. |
| Databáze: | OpenAIRE |
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