Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical Therapy
ObjectiveTo explore the impact on microvascular complications, long-term preservation of residual B-cell function and glycemic control of patients with type 1 diabetes treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) compared with conventional medical therapy (...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-11-01
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| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/article/10.3389/fendo.2017.00331/full |
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| author | Jaquellyne G. Penaforte-Saboia Renan M. Montenegro Renan M. Montenegro Carlos E. Couri Carlos E. Couri Livia A. Batista Ana Paula D. R. Montenegro Virginia O. Fernandes Hussain Akhtar Hussain Akhtar Carlos A. Negrato Kelen Cristina Ribeiro Malmegrim Daniela Aparecida Moraes Daniela Aparecida Moraes Juliana B. E. Dias Juliana B. E. Dias Belinda P. Simões Belinda P. Simões Marilia Brito Gomes Maria Carolina Oliveira Maria Carolina Oliveira |
| author_facet | Jaquellyne G. Penaforte-Saboia Renan M. Montenegro Renan M. Montenegro Carlos E. Couri Carlos E. Couri Livia A. Batista Ana Paula D. R. Montenegro Virginia O. Fernandes Hussain Akhtar Hussain Akhtar Carlos A. Negrato Kelen Cristina Ribeiro Malmegrim Daniela Aparecida Moraes Daniela Aparecida Moraes Juliana B. E. Dias Juliana B. E. Dias Belinda P. Simões Belinda P. Simões Marilia Brito Gomes Maria Carolina Oliveira Maria Carolina Oliveira |
| author_sort | Jaquellyne G. Penaforte-Saboia |
| collection | DOAJ |
| description | ObjectiveTo explore the impact on microvascular complications, long-term preservation of residual B-cell function and glycemic control of patients with type 1 diabetes treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) compared with conventional medical therapy (CT).Research design and methodsCross-sectional data of patients treated with AHST were compared with patients who received conventional therapy from the Brazilian Type 1 Diabetes Study Group, the largest multicenter observational study in type 1 diabetes mellitus in Brazil. Both groups of patients had diabetes for 8 years on average. An assessment comparison was made on the presence of microvascular complications, residual function of B cell, A1c, and insulin dose of the patients.ResultsAfter a median of 8 years of diagnosis, none of the AHST-treated patients (n = 24) developed microvascular complications, while 21.5% (31/144) had at least one (p < 0.005) complication in the CT group (n = 144). Furthermore, no case of nephropathy was reported in the AHST group, while 13.8% of CT group (p < 0.005) developed nephropathy during the same period. With regard of residual B-cell function, the percentage of individuals with predicted higher C-peptide levels (IDAA1C ≤ 9) was about 10-fold higher in the AHST group compared with CT (75 vs. 8.3%) (p < 0.001) group. Among AHST patients, 54.1% (13/24) had the HbA1c < 7.0 compared with 13.1% in the CT (p < 0.001) group.ConclusionPatients with newly diagnosed type 1 diabetes treated with AHST presented lower prevalence of microvascular complications, higher residual B-cell function, and better glycemic control compared with the CT group. |
| first_indexed | 2024-04-12T21:33:17Z |
| format | Article |
| id | doaj.art-1a40998c5f0f45528b0094c5965950b2 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-12T21:33:17Z |
| publishDate | 2017-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-1a40998c5f0f45528b0094c5965950b22022-12-22T03:15:58ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922017-11-01810.3389/fendo.2017.00331305551Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical TherapyJaquellyne G. Penaforte-Saboia0Renan M. Montenegro1Renan M. Montenegro2Carlos E. Couri3Carlos E. Couri4Livia A. Batista5Ana Paula D. R. Montenegro6Virginia O. Fernandes7Hussain Akhtar8Hussain Akhtar9Carlos A. Negrato10Kelen Cristina Ribeiro Malmegrim11Daniela Aparecida Moraes12Daniela Aparecida Moraes13Juliana B. E. Dias14Juliana B. E. Dias15Belinda P. Simões16Belinda P. Simões17Marilia Brito Gomes18Maria Carolina Oliveira19Maria Carolina Oliveira20Post Graduate Program in Medical Sciences, Federal University of Ceará, Ceará, BrazilPost Graduate Program in Medical Sciences, Federal University of Ceará, Ceará, BrazilFederal University of Ceará, Ceará, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilPost Graduate Program in Medical Sciences, Federal University of Ceará, Ceará, BrazilFederal University of Ceará, Ceará, BrazilFederal University of Ceará, Ceará, BrazilFederal University of Ceará, Ceará, BrazilUniversity of Oslo, UIO, Oslo, NoruegaBrazilian Society of Diabetes, São Paulo, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilState University of Rio de Janeiro, Rio de Janeiro, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilObjectiveTo explore the impact on microvascular complications, long-term preservation of residual B-cell function and glycemic control of patients with type 1 diabetes treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) compared with conventional medical therapy (CT).Research design and methodsCross-sectional data of patients treated with AHST were compared with patients who received conventional therapy from the Brazilian Type 1 Diabetes Study Group, the largest multicenter observational study in type 1 diabetes mellitus in Brazil. Both groups of patients had diabetes for 8 years on average. An assessment comparison was made on the presence of microvascular complications, residual function of B cell, A1c, and insulin dose of the patients.ResultsAfter a median of 8 years of diagnosis, none of the AHST-treated patients (n = 24) developed microvascular complications, while 21.5% (31/144) had at least one (p < 0.005) complication in the CT group (n = 144). Furthermore, no case of nephropathy was reported in the AHST group, while 13.8% of CT group (p < 0.005) developed nephropathy during the same period. With regard of residual B-cell function, the percentage of individuals with predicted higher C-peptide levels (IDAA1C ≤ 9) was about 10-fold higher in the AHST group compared with CT (75 vs. 8.3%) (p < 0.001) group. Among AHST patients, 54.1% (13/24) had the HbA1c < 7.0 compared with 13.1% in the CT (p < 0.001) group.ConclusionPatients with newly diagnosed type 1 diabetes treated with AHST presented lower prevalence of microvascular complications, higher residual B-cell function, and better glycemic control compared with the CT group.http://journal.frontiersin.org/article/10.3389/fendo.2017.00331/fulltype 1 diabetesautologous nonmyeloablative hematopoietic stem-cell transplantationresidual B-cell functionglycemic controlmicrovascular complications |
| spellingShingle | Jaquellyne G. Penaforte-Saboia Renan M. Montenegro Renan M. Montenegro Carlos E. Couri Carlos E. Couri Livia A. Batista Ana Paula D. R. Montenegro Virginia O. Fernandes Hussain Akhtar Hussain Akhtar Carlos A. Negrato Kelen Cristina Ribeiro Malmegrim Daniela Aparecida Moraes Daniela Aparecida Moraes Juliana B. E. Dias Juliana B. E. Dias Belinda P. Simões Belinda P. Simões Marilia Brito Gomes Maria Carolina Oliveira Maria Carolina Oliveira Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical Therapy Frontiers in Endocrinology type 1 diabetes autologous nonmyeloablative hematopoietic stem-cell transplantation residual B-cell function glycemic control microvascular complications |
| title | Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical Therapy |
| title_full | Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical Therapy |
| title_fullStr | Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical Therapy |
| title_full_unstemmed | Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical Therapy |
| title_short | Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical Therapy |
| title_sort | microvascular complications in type 1 diabetes a comparative analysis of patients treated with autologous nonmyeloablative hematopoietic stem cell transplantation and conventional medical therapy |
| topic | type 1 diabetes autologous nonmyeloablative hematopoietic stem-cell transplantation residual B-cell function glycemic control microvascular complications |
| url | http://journal.frontiersin.org/article/10.3389/fendo.2017.00331/full |
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