Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients.

Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients. Research Abstract Details 

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Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients. Abstract Text:

Michael R Rickels,Mark H Schutta,Rebecca Mueller,Shiv Kapoor,James F Markmann,Ali Naji,Karen L Teff,

CONTEXT: In patients with type 1 diabetes and reduced awareness of hypoglycemia, the glycemic thresholds for activation of counterregulatory hormone and symptom responses to hypoglycemia are impaired, in part due to recurrent episodes of hypoglycemia. Islet transplantation can ameliorate occurrences of hypoglycemia in these patients. OBJECTIVE: The objective of the study was to determine whether the avoidance of hypoglycemia achieved through islet transplantation results in improved glycemic thresholds for counterregulatory responses. SETTING: The study was conducted at a general clinical research center. PARTICIPANTS: Seven islet transplant recipients, six type 1 diabetic, and eight nondiabetic control subjects participated in the study. INTERVENTION: We performed a stepped hyperinsulinemic hypoglycemic clamp and, in 12 subjects, a paired hyperinsulinemic euglycemic clamp to calculate the glycemic thresholds for and magnitude of counterregulatory responses. RESULTS: The glycemic thresholds for all counterregulatory hormone and symptom responses in the islet transplant group were comparable with normal and higher than in the type 1 diabetes group (P < 0.01 for glucagon; P < 0.05 for epinephrine). The magnitude of the glucagon and epinephrine responses in the islet transplant group, although greater than in the type 1 diabetes group (P < 0.05 for both), remained less than normal (P < 0.01 for glucagon; P < 0.05 for epinephrine). The magnitude of GH secretion in the islet transplant group was comparable with normal and greater than in the type 1 diabetes group (P < 0.05). CONCLUSIONS: The glycemic thresholds for activation of counterregulatory hormone and symptom responses appear normal after islet transplantation; however, the magnitudes of the glucagon and epinephrine responses remain impaired.

Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients. Publishing Authors By Initials

MR Rickels,MH Schutta,R Mueller,S Kapoor,JF Markmann,A Naji,KL Teff,

For similar surgical procedures, operative: transplantation research abstracts see: surgical procedures, operative: transplantation research

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Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: The Journal of clinical endocrinology and metaboli

VOLUME: 92

Page Numbers: 873-9

Journal Abbreviation: J. Clin. Endocrinol. Metab.

ISSN: 0021-972X

DAY: 27

MONTH: 12

YEAR: 2006

Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients. Information

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LANGUAGE: eng

NlmUniqueID: 375362

Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients. Keywords Mesh Terms:

KEYWORDS: Transplantation

MESH TERMS: blood

Chemical & Substance for Abstract: Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients. Information

Substance Name: Glucagon

Registry Number: 9007-92-5

Grant and Affiliation Information for Glycemic thresholds for activation of counterregulatory hormone and symptom responses in islet transplant recipients.

AFFILIATION: University of Pennsylvania School of Medicine, Division of Endocrinology, Diabetes, and Metabolism, 778 Clinical Research Building, 415 Curie Boulevard, Philadelphia, Pennsylvania 19104-6149, USA. rickels@mail.med.upenn.edu

Country: United States

AGENCY: United States NCRR

GRANT: U42-RR016600

ACRONYM: RR

MEDLINETA: J Clin Endocrinol Metab

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