Donor insulin use predicts beta-cell function after islet transplantation

Iestyn M. Shapey; Angela Summers; Petros Yiannoullou; Hussein Khambalia; Catherine Fullwood; Neil A. Hanley; John Casey; Shareen Forbes; Miranda Rosenthal; Paul R.V. Johnson; Pratik Choudhary; James Bushnell; James A.M. Shaw; Titus Augustine; Martin K. Rutter; David van Dellen

doi:10.1111/dom.14088

Donor insulin use predicts beta-cell function after islet transplantation

Iestyn M. Shapey^*, Angela Summers, Petros Yiannoullou, Hussein Khambalia, Catherine Fullwood, Neil A. Hanley, John Casey, Shareen Forbes, Miranda Rosenthal, Paul R.V. Johnson, Pratik Choudhary, James Bushnell, James A.M. Shaw, Titus Augustine, Martin K. Rutter, David van Dellen

^*Corresponding author for this work

Medicine and Health

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Insulin is routinely used to manage hyperglycaemia in organ donors and during the peri-transplant period in islet transplant recipients. However, it is unknown whether donor insulin use (DIU) predicts beta-cell dysfunction after islet transplantation. We reviewed data from the UK Transplant Registry and the UK Islet Transplant Consortium; all first-time transplants during 2008-2016 were included. Linear regression models determined associations between DIU, median and coefficient of variation (CV) peri-transplant glucose levels and 3-month islet graft function. In 91 islet cell transplant recipients, DIU was associated with lower islet function assessed by BETA-2 scores (β [SE] -3.5 [1.5], P =.02), higher 3-month post-transplant HbA1c levels (5.4 [2.6] mmol/mol, P =.04) and lower fasting C-peptide levels (−107.9 [46.1] pmol/l, P =.02). Glucose at 10 512 time points was recorded during the first 5 days peri-transplant: the median (IQR) daily glucose level was 7.9 (7.0-8.9) mmol/L and glucose CV was 28% (21%-35%). Neither median glucose levels nor glucose CV predicted outcomes post-transplantation. Data on DIU predicts beta-cell dysfunction 3 months after islet transplantation and could help improve donor selection and transplant outcomes.

Original language	English
Pages (from-to)	1874-1879
Number of pages	6
Journal	Diabetes, Obesity and Metabolism
Volume	22
Issue number	10
DOIs	https://doi.org/10.1111/dom.14088
Publication status	Published - 1 Oct 2020

Bibliographical note

Funding Information:
This study was funded by the Medical Research Council, the Royal College of Surgeons of Edinburgh and Diabetes UK. Funding information

Publisher Copyright:
© 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Keywords

insulin
islet
organ donor
pancreas
transplant

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Endocrinology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/dom.14088

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Shapey, I. M., Summers, A., Yiannoullou, P., Khambalia, H., Fullwood, C., Hanley, N. A., Casey, J., Forbes, S., Rosenthal, M., Johnson, P. R. V., Choudhary, P., Bushnell, J., Shaw, J. A. M., Augustine, T., Rutter, M. K., & van Dellen, D. (2020). Donor insulin use predicts beta-cell function after islet transplantation. Diabetes, Obesity and Metabolism, 22(10), 1874-1879. https://doi.org/10.1111/dom.14088

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title = "Donor insulin use predicts beta-cell function after islet transplantation",

abstract = "Insulin is routinely used to manage hyperglycaemia in organ donors and during the peri-transplant period in islet transplant recipients. However, it is unknown whether donor insulin use (DIU) predicts beta-cell dysfunction after islet transplantation. We reviewed data from the UK Transplant Registry and the UK Islet Transplant Consortium; all first-time transplants during 2008-2016 were included. Linear regression models determined associations between DIU, median and coefficient of variation (CV) peri-transplant glucose levels and 3-month islet graft function. In 91 islet cell transplant recipients, DIU was associated with lower islet function assessed by BETA-2 scores (β [SE] -3.5 [1.5], P =.02), higher 3-month post-transplant HbA1c levels (5.4 [2.6] mmol/mol, P =.04) and lower fasting C-peptide levels (−107.9 [46.1] pmol/l, P =.02). Glucose at 10 512 time points was recorded during the first 5 days peri-transplant: the median (IQR) daily glucose level was 7.9 (7.0-8.9) mmol/L and glucose CV was 28% (21%-35%). Neither median glucose levels nor glucose CV predicted outcomes post-transplantation. Data on DIU predicts beta-cell dysfunction 3 months after islet transplantation and could help improve donor selection and transplant outcomes.",

keywords = "insulin, islet, organ donor, pancreas, transplant",

author = "Shapey, {Iestyn M.} and Angela Summers and Petros Yiannoullou and Hussein Khambalia and Catherine Fullwood and Hanley, {Neil A.} and John Casey and Shareen Forbes and Miranda Rosenthal and Johnson, {Paul R.V.} and Pratik Choudhary and James Bushnell and Shaw, {James A.M.} and Titus Augustine and Rutter, {Martin K.} and {van Dellen}, David",

note = "Funding Information: This study was funded by the Medical Research Council, the Royal College of Surgeons of Edinburgh and Diabetes UK. Funding information Publisher Copyright: {\textcopyright} 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.",

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Shapey, IM, Summers, A, Yiannoullou, P, Khambalia, H, Fullwood, C, Hanley, NA, Casey, J, Forbes, S, Rosenthal, M, Johnson, PRV, Choudhary, P, Bushnell, J, Shaw, JAM, Augustine, T, Rutter, MK & van Dellen, D 2020, 'Donor insulin use predicts beta-cell function after islet transplantation', Diabetes, Obesity and Metabolism, vol. 22, no. 10, pp. 1874-1879. https://doi.org/10.1111/dom.14088

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AU - Shapey, Iestyn M.

AU - Summers, Angela

AU - Yiannoullou, Petros

AU - Khambalia, Hussein

AU - Fullwood, Catherine

AU - Hanley, Neil A.

AU - Casey, John

AU - Forbes, Shareen

AU - Rosenthal, Miranda

AU - Johnson, Paul R.V.

AU - Choudhary, Pratik

AU - Bushnell, James

AU - Shaw, James A.M.

AU - Augustine, Titus

AU - Rutter, Martin K.

AU - van Dellen, David

N1 - Funding Information: This study was funded by the Medical Research Council, the Royal College of Surgeons of Edinburgh and Diabetes UK. Funding information Publisher Copyright: © 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

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Y1 - 2020/10/1

N2 - Insulin is routinely used to manage hyperglycaemia in organ donors and during the peri-transplant period in islet transplant recipients. However, it is unknown whether donor insulin use (DIU) predicts beta-cell dysfunction after islet transplantation. We reviewed data from the UK Transplant Registry and the UK Islet Transplant Consortium; all first-time transplants during 2008-2016 were included. Linear regression models determined associations between DIU, median and coefficient of variation (CV) peri-transplant glucose levels and 3-month islet graft function. In 91 islet cell transplant recipients, DIU was associated with lower islet function assessed by BETA-2 scores (β [SE] -3.5 [1.5], P =.02), higher 3-month post-transplant HbA1c levels (5.4 [2.6] mmol/mol, P =.04) and lower fasting C-peptide levels (−107.9 [46.1] pmol/l, P =.02). Glucose at 10 512 time points was recorded during the first 5 days peri-transplant: the median (IQR) daily glucose level was 7.9 (7.0-8.9) mmol/L and glucose CV was 28% (21%-35%). Neither median glucose levels nor glucose CV predicted outcomes post-transplantation. Data on DIU predicts beta-cell dysfunction 3 months after islet transplantation and could help improve donor selection and transplant outcomes.

AB - Insulin is routinely used to manage hyperglycaemia in organ donors and during the peri-transplant period in islet transplant recipients. However, it is unknown whether donor insulin use (DIU) predicts beta-cell dysfunction after islet transplantation. We reviewed data from the UK Transplant Registry and the UK Islet Transplant Consortium; all first-time transplants during 2008-2016 were included. Linear regression models determined associations between DIU, median and coefficient of variation (CV) peri-transplant glucose levels and 3-month islet graft function. In 91 islet cell transplant recipients, DIU was associated with lower islet function assessed by BETA-2 scores (β [SE] -3.5 [1.5], P =.02), higher 3-month post-transplant HbA1c levels (5.4 [2.6] mmol/mol, P =.04) and lower fasting C-peptide levels (−107.9 [46.1] pmol/l, P =.02). Glucose at 10 512 time points was recorded during the first 5 days peri-transplant: the median (IQR) daily glucose level was 7.9 (7.0-8.9) mmol/L and glucose CV was 28% (21%-35%). Neither median glucose levels nor glucose CV predicted outcomes post-transplantation. Data on DIU predicts beta-cell dysfunction 3 months after islet transplantation and could help improve donor selection and transplant outcomes.

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KW - organ donor

KW - pancreas

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Donor insulin use predicts beta-cell function after islet transplantation

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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