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Schwindt S.T.,University of Alberta | Hubert G.,Clinical Islet Transplant Program | Koh A.,Clinical Islet Transplant Program | Shapiro A.M.J.,Clinical Islet Transplant Program | And 2 more authors.
Canadian Journal of Diabetes | Year: 2012

Clinical islet transplantation (CIT) has emerged as an effective therapy for type 1 diabetes mellitus. Adults undergoing CIT are at high risk for reduced bone mineral density (BMD) due to poor nutritional status, use of immunosuppressive therapy known to influence bone metabolism and ongoing refractory disease. The objective of this study was to determine the prevalence of reduced BMD in CIT recipients. A retrospective pair-matched study design was conducted in adults with type 1 diabetes pre- and post-CIT (n=18). BMD was measured using dual x-ray absorptiometry (DXA) at the femoral neck (FN), hip and spine. Overall, absolute BMD (g/cm2) did not decrease significantly between pre- and post-CIT measures (p>0.05). Routine evaluation of BMD including variables known to influence bone health (medications, lifestyle factors), is warranted in patients undergoing CIT. © 2012 Canadian Diabetes Association.

PubMed | University of Alberta and Clinical Islet Transplant Program.
Type: | Journal: Diabetic medicine : a journal of the British Diabetic Association | Year: 2016

Resuming insulin use due to waning function is common after islet transplantation. Animal studies suggest that gastrointestinal hormones, including gastrin and incretins may increase -cell mass. We tested the hypothesis that pantoprazole plus sitagliptin, would restore insulin independence in islet transplant recipients with early graft insufficiency and determined whether this would persist after a 3-month washout.Single-centre, uncontrolled, open label study of sitagliptin 100mg daily plus pantoprazole 40mg twice daily for 6months.After 6months of treatment, two of eight participants (25%) achieved the primary endpoint, defined as HbASitagliptin plus pantoprazole is well tolerated and safe and may restore insulin independence in some islet transplant recipients with early graft insufficiency, but this was not sustained when treatment was withdrawn. A larger, controlled trial is required to confirm the effectiveness of this combination to achieve insulin independence and to confidently exclude any persistent benefit for graft function. (Clinical Trials Registry No.: NCT00768651) This article is protected by copyright. All rights reserved.

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