Advances in β-cell replacement therapy for the treatment of type 1 diabetes

Marie-Christine Vantyghem, Eelco J P de Koning, François Pattou, Michael R Rickels

Research output: Contribution to journal/periodicalArticleScientificpeer-review

Abstract

The main goal of treatment for type 1 diabetes is to control glycaemia with insulin therapy to reduce disease complications. For some patients, technological approaches to insulin delivery are inadequate, and allogeneic islet transplantation is a safe alternative for those patients who have had severe hypoglycaemia complicated by impaired hypoglycaemia awareness or glycaemic lability, or who already receive immunosuppressive drugs for a kidney transplant. Since 2000, intrahepatic islet transplantation has proven efficacious in alleviating the burden of labile diabetes and preventing complications related to diabetes, whether or not a previous kidney transplant is present. Age, body-mass index, renal status, and cardiopulmonary status affect the choice between pancreas or islet transplantation. Access to transplantation is limited by the number of deceased donors and the necessity of immunosuppression. Future approaches might include alternative sources of islets (eg, xenogeneic tissue or human stem cells), extrahepatic sites of implantation (eg, omental, subcutaneous, or intramuscular), and induction of immune tolerance or encapsulation of islets.

Original languageEnglish
Pages (from-to)1274-1285
Number of pages12
JournalThe Lancet
Volume394
Issue number10205
DOIs
Publication statusPublished - 05 Oct 2019

Keywords

  • Diabetes Mellitus, Type 1/surgery
  • Graft Rejection/prevention & control
  • Humans
  • Immunosuppression
  • Insulin-Secreting Cells/transplantation
  • Treatment Outcome

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