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Transplants

A Type 1 Breakthrough: Can We Transplant Islets With Less Toxic Immunosuppression?

Medical illustration of transplanted pancreatic islet cells protected from immune attack during experimental type 1 diabetes treatment.

Donor islet transplantation has long offered an intriguing possibility for people with severe type 1 diabetes: restore the body’s ability to make insulin instead of only replacing insulin from the outside. However, there has always been a major tradeoff. Patients need powerful immunosuppressive drugs to keep transplanted cells alive, and …

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Could Stem Cell Therapy Change Type 1 Diabetes Forever? Preparing for the Next Era of Care

Illustration of stem cell-derived pancreatic islet cells, a pancreas, and a person with type 1 diabetes using a glucose monitor, representing advances in stem cell islet transplant diabetes therapy.

For more than a century, insulin has been the foundation of type 1 diabetes care. However, even the best insulin pumps, continuous glucose monitors, and automated insulin delivery systems still cannot fully replace the body’s lost beta cells. That is why interest in stem cell islet transplant diabetes research continues …

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Managing Diabetes Around Organ Transplant Surgery: What Clinicians Need to Know

Medical team performing organ transplant surgery with glucose monitoring tools, immunosuppressive medications, and diabetes management equipment in a hospital setting.

The management of diabetes during organ transplantation has become a growing clinical challenge. As transplant programs expand and survival rates improve, more patients are living with complex metabolic complications before and after surgery. One of the most important concerns is post-transplant hyperglycemia, which can affect patient outcomes at nearly every …

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Practical Diabetes Care, 3rd Ed., Excerpt #16: Diabetic Renal Disease Part 5 of 5

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David Levy, MD, FRCP Renal replacement therapy The decision to start dialysis is often difficult. The clinical decision is based on many factors, including the presence of uremic symptoms and weight loss, and biochemical measurements including serum creatinine (e.g. serum creatinine 700–800 μmol/L(small mu), eGFR < 12–14 mL/min, falling albumin, hyperkalemia). …

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Practical Diabetes Care, 3rd Ed., Excerpt #4: Type 1 Diabetes: Insulin Treatment Part 1 of 2

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David Levy, MD, FRCP Introduction Insulin treatment in type 1 diabetes is substitution/replacement hormone treatment, but replacement is much more variable and difficult to achieve than in other hormone deficiencies (e.g. thyroid, adrenal, gonadal hormones) because of the minute-by-minute variation in insulin secretion by the intact pancreas, which cannot yet be …

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