Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with “brittle T1DM”, who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and […]

The best comprehension about the instability of the glycemia levels in type 1 diabetes mellitus (T1DM) patients and the availability of new alternatives to successfully control it, like insulin pump therapy and the insulin analogues, underlined the questions about the brittle diabetes existence as a clinical entity as well as the necessity of define it. The aim of this article was to describe the concept of brittle diabetes in the light of the latest advances in the treatment of type […]

Islet transplant is an innovative treatment for type 1 diabetic patients, which still lies between experimental and approved transplant therapy. Islet cells are seeded in a non-physiological territory where an uncertain fraction will be able to adapt and survive. Thus, the challenge lies in improving the whole procedure, employing the tools of cell biology, immunology and laboratory techniques, in order to reach the results obtained with whole organ transplant. This review describes the procedure, its progress to the present methodology […]

BACKGROUND: Our intention is to describe the clinical profile of the candidates for islet transplantation in Curitiba, Brazil. METHODS: The clinical evaluation was organized in stages: Screening, Initial Evaluation, Evaluation and Waiting List. Candidates’ inclusion criteria were hypoglycemia unawareness, glycemic imbalance, chronic progressive diabetic complications, 18-65 years of age and at least 5 years of type 1 diabetes evolution. RESULTS: From September 2003 through September 2006, 92 candidates were clinically evaluated, and 25 fulfilled the Screening criteria, being selected at […]