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New-Onset Diabetes Mellitus After Kidney Transplantation: The Role of Immunosuppression


In a step toward curing diabetes in humans, scientists at Washington University School of Medicine in St. Various autoantibodies (for example, against islet cells, adrenals, thyroid, gastric mucosa and intrinsic factor) have also been found in patients with polyendocrine disease1,2,8,9. Such a protocol also results in long-term rat islet xenograft survival in mice made diabetic by streptozotocin. Throughout the pancreas are clusters of cells called the islets of Langerhans. Adverse events (AEs) in patients were followed and graded using the Common Terminology Criteria for Adverse Events, version 3.0 (National Cancer Institute). Insulin is a hormone that helps the body use glucose for energy. Conventional maintenance regimens consist of a combination of immunosuppressive agents that differ by mechanism of action.

The patient did not achieve complete insulin independence post-transplant but reduced his daily insulin to approximately 17 U. Even with intense insulin treatment, mean glycosylated hemoglobin levels were a gram percent above normal.3 Furthermore, some individuals have extreme oscillations of blood glucose no matter what the regimen, and others develop secondary complications even when glycosylated hemoglobin levels are only moderately elevated. During a 7- to 36-month follow-up (mean 18.8), 14 patients became insulin-free (1 for 35 months, 4 for at least 21 months, 7 for at least 6 months; and 2 with late response were insulin-free for 1 and 5 months, respectively).

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