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- November 20, 2008 |
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"Transplantation in Diabetes Management"Dr. Philip O'Connell (biography)
English - 2006-02-20 - 54 minutes
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Summary :
In this presentation Dr. O'Connell talks about the rationale for transplantation in diabetes, which patients are eligible for these procedures, and how this field is likely to progress.
In type 1 diabetic patients, intensive insulin treatment has been associated with reduced complications, however aggressive control with exogenous insulin increases the risk of severe hypoglycemia (1). Simultaneous pancreas kidney transplantation is reserved for type 1 diabetic patients with renal failure, for whom it can significantly improve the quality of life and the clinical benefits include normalisation of renal function and glycemic control.
Pancreatic islet transplantation is a promising but as yet experimental technique. In 2000 a group from Edmonton Canada reported the successful achievement of insulin independence in type 1 diabetic patients with a history of severe hypoglycemia, who underwent islet transplantation in conjunction with a glucocorticoid-free immunosuppressive regimen (2).
The publication of these results raised several questions, such as whether the results are transferable to other units, which group of patients should be transplanted, what are the medium and long-term outcomes and the impact on secondary complications, and what is the "cost" of islet transplantation. Dr. O'Connell presents further studies addressing these questions, and concludes with a discussion on the current status and future directions for islet transplantation.
Copyright © 2006 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The rationale for transplantation in subsets of diabetic patients
- Benefits of simultaneous pancreas kidney transplantation
- Pancreatic islet transplantation: history, current status and future goals
Bibliographic references :
1. The Diabetes Control and Complications Trial Research GroupThe Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus NEJM 1993;329:977-986.
2. A.M. James Shapiro, M.B., B.S., Jonathan R.T. Lakey, Ph.D., Edmond A. Ryan, M.D., Gregory S. Korbutt, Ph.D., Ellen Toth, M.D., Garth L. Warnock, M.D., Norman M. Kneteman, M.D., and Ray V. Rajotte, Ph.D.Islet Transplantation in Seven Patients with Type 1 Diabetes Mellitus Using a Glucocorticoid-Free Immunosuppressive Regimen NEJM 2000;343:230-238.
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