Fasting parameters for estimation of stimulated β cell function in islet transplant recipients with or without basal insulin treatment

© 2020 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons..

In order to assess β cell secretory capacity after islet transplantation, standardized mixed meal stimulation tests are often used. But these tests are cumbersome and the effect of exogenous insulin on the test results is unclear. The aim of our study was to determine to what extent fasting glycemic indices can estimate stimulated β cell function in islet transplant recipients with and without basal insulin. In total 100 mixed meal stimulation tests, including 31 with concurrent basal insulin treatment, were performed in 36 islet transplant recipients. In a multivariate model, fasting C-peptide and fasting glucose together estimated peak C-peptide with R2  = .87 and area under the curve (AUC) C-peptide with a R2  = .93. There was a larger increase of glucose during tests in which exogenous insulin was used (+7.9 vs +5.3 mmol/L, P < .001) and exogenous insulin use was associated with a slightly lower estimated peak C-peptide (relative change: -15%, P = .02). In islet transplant recipients the combination of fasting C-peptide and glucose can be used to accurately estimate stimulated β cell function after a mixed meal stimulation test, whether exogenous basal insulin is present or not. These data indicate that graft function can be reliably determined during exogenous insulin treatment and that regular islet graft stimulation tests can be minimized.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:21

Enthalten in:

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons - 21(2021), 1 vom: 14. Jan., Seite 297-306

Sprache:

Englisch

Beteiligte Personen:

Uitbeijerse, Bas S [VerfasserIn]
Nijhoff, Michiel F [VerfasserIn]
Sont, Jacob K [VerfasserIn]
de Koning, Eelco J P [VerfasserIn]

Links:

Volltext

Themen:

Blood Glucose
C-Peptide
Clinical research/practice
Diabetes
Endocrinology/diabetology
Insulin
Insulin/C-peptide
Islet transplantation
Islets of Langerhans
Journal Article

Anmerkungen:

Date Completed 18.06.2021

Date Revised 24.01.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/ajt.16135

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM311039855