{"doi":"10.2337/dc24-1915","title":"Islet Transplantation Versus Standard of Care for Type 1 Diabetes Complicated by Severe Hypoglycemia From the Collaborative Islet Transplant Registry and the T1D Exchange Registry","abstract":"OBJECTIVE: Islet transplantation was recently approved by the U.S. Food and Drug Administration for adults with type 1 diabetes complicated by recurrent severe hypoglycemia events (SHEs). We sought to understand the long-term benefit for glycemic control and risk of immunosuppression to kidney function associated with islet transplantation compared with ongoing standard of care. RESEARCH DESIGN AND METHODS: We performed a case-control analysis of prospectively collected data from patients in the Collaborative Islet Transplant Registry (CITR) with at least one SHE in the year (2000-2014) before transplantation (case subjects) and compared them with data from patients in the T1D Exchange (T1DX) Registry with at least one SHE in the year (2010-2012) before enrollment (control subjects), with both cohorts observed over 5 years. SHEs were restricted to those resulting in seizure or loss of consciousness. RESULTS: Case subjects from CITR (n = 71) compared with control subjects from T1DX (n = 213) more often achieved the primary outcome of HbA1c <7.0% and absence of an SHE (71-80% vs. 21-33% over 5 years; P < 0.001) and the outcome of HbA1c ≤6.5% and absence of an SHE (60-75% vs. 10-20%; P < 0.001) while requiring significantly less insulin (majority in CITR were insulin independent). Kidney function, measured by estimated glomerular filtration rate, declined from baseline to a greater extent in CITR than in T1DX (-8.8 to -20 vs. -1.3 to -6.5 mL ⋅ min-1 ⋅ 1.73 m-2 over 5 years; P < 0.001). CONCLUSIONS: Islet transplantation for adults with type 1 diabetes complicated by SHEs results in near-normal glycemic control in the absence of SHEs more often than observed with standard of care, but at the cost of greater reduction in kidney function.","journal":"Diabetes Care","year":2025,"id":529954,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9525,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1026728,"name":"Cassandra Ballou","orcid":"0000-0003-0097-5599","position":1,"is_corresponding":false},{"id":969543,"name":"Nicole C. Foster","orcid":"0000-0003-3485-6977","position":2,"is_corresponding":false},{"id":351272,"name":"Rodolfo Alejandro","orcid":"0000-0003-4387-5360","position":3,"is_corresponding":false},{"id":336605,"name":"David A. Baidal","orcid":"0000-0001-7694-3265","position":4,"is_corresponding":false},{"id":7392,"name":"Melena D. Bellin","orcid":"0000-0002-7324-4837","position":5,"is_corresponding":false},{"id":535624,"name":"Thomas L. Eggerman","orcid":null,"position":6,"is_corresponding":false},{"id":275493,"name":"Bernhard J. Hering","orcid":"0000-0002-5962-7284","position":7,"is_corresponding":false},{"id":351268,"name":"Fouad Kandeel","orcid":"0000-0003-3746-5015","position":8,"is_corresponding":false},{"id":801864,"name":"Adam Brand","orcid":"0000-0003-1300-5292","position":9,"is_corresponding":false},{"id":231691,"name":"Kellee M. Miller","orcid":"0000-0002-5684-8284","position":10,"is_corresponding":false},{"id":1026730,"name":"Franca B. Barton","orcid":"0000-0002-6628-5745","position":11,"is_corresponding":false},{"id":1026729,"name":"Elizabeth H. Payne","orcid":"0000-0003-0905-7647","position":12,"is_corresponding":false},{"id":231672,"name":"Michael R. Rickels","orcid":"0000-0002-9253-838X","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:51:01.235017Z","pmid":"39951130","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}