Islet Transplantation in Type 1 Diabetes

Completed · Phase 3

Conditions studied: Type 1 Diabetes Mellitus

In brief

Type 1 diabetes is an autoimmune disease in which the insulin-producing pancreatic beta cells are destroyed, resulting in poor blood sugar control. The purpose of this study is to determine the safety and effectiveness of islet transplantation, combined with immunosuppressive medications, for treating type 1 diabetes in individuals experiencing hypoglycemia unawareness and severe hypoglycemic episodes.

Key facts

Study ID

NCT00434811

Run by

National Institute of Allergy and Infectious Diseases (NIAID)

People needed

48

Starts

2006-10-01

Expected to finish

2014-05-01

Last updated by the study team

2019-07-17

Who can join

Age: 18 and older, up to 65. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Mentally stable and able to comply with study procedures
• Clinical history compatible with type 1 diabetes with onset of disease at less than 40 years of age, insulin dependence for at least 5 years at study entry, and a sum of age and insulin dependent diabetes duration of at least 28
• Absent stimulated C-peptide (less than 0.3 ng/ml) 60 and 90 minutes post-mixed-meal tolerance test
• Involvement of intensive diabetes management, defined as:
• Self-monitoring of glucose values no less than a mean of three times each day averaged over each week
• Administration of three or more insulin injections each day or insulin pump therapy
• Under the direction of an endocrinologist, diabetologist, or diabetes specialist with at least three clinical evaluations during the past 12 months prior to study enrollment
• At least one episode of severe hypoglycemia in the past 12 months, defined as an event with one of the following symptoms: memory loss; confusion; uncontrollable behavior; irrational behavior; unusual difficulty in awakening; suspected seizure; seizure; loss of consciousness; or visual symptoms, compatible with hypoglycemia in which the individual required assistance of another subject was unable to treat him/herself person and which was associated with either a blood glucose level less than 54 mg/dl or prompt recovery after oral carbohydrate, intravenous glucose, or glucagon administration in the 12 months prior to study enrollment
• Reduced awareness of hypoglycemia. More information about this criterion, including specific definition of hypoglycemia unawareness, is in the protocol.

You may not qualify if…

• Body mass index (BMI) greater than 30 kg/m2 or weight less than or equal to 50 kg
• Insulin requirement of more than 1.0 IU/kg/day or less than 15 U/day
• HbA1c greater than 10%
• Untreated proliferative diabetic retinopathy
• Systolic blood pressure higher than 160 mmHg or diastolic blood pressure higher than 100 mmHg
• Measured glomerular filtration rate using iohexol of less than 80 ml/min/1.73mm2. More information about this criterion is in the protocol.
• Presence or history of macroalbuminuria (greater than 300 mg/g creatinine)
• Presence or history of panel-reactive anti-HLA antibody levels greater than background by flow cytometry. More information about this criterion is in the protocol.
• Pregnant, breastfeeding, or unwilling to use effective contraception throughout the study and 4 months after study completion
• Presence or history of active infection, including hepatitis B, hepatitis C, HIV, or tuberculosis.
• Negative for Epstein-Barr virus by IgG determination
• Invasive aspergillus, histoplasmosis, or coccidioidomycosis infection in the past year
• History of malignancy except for completely resected squamous or basal cell carcinoma of the skin
• Known active alcohol or substance abuse
• Baseline Hgb below the lower limits of normal, lymphopenia, neutropenia, or thrombocytopenia
• History of Factor V deficiency
• Any coagulopathy or medical condition requiring long-term anticoagulant therapy after transplantation or individuals with an INR greater than 1.5
• Severe coexisting cardiac disease, characterized by any one of the following conditions:
• Heart attack within the last 6 months
• Evidence of ischemia on functional heart exam within the year prior to study entry
• Left ventricular ejection fraction less than 30%
• Persistent elevation of liver function tests at the time of study entry
• Symptomatic cholecystolithiasis
• Acute or chronic pancreatitis
• Symptomatic peptic ulcer disease

Where it is running

• University of Callifornia, San Francisco — San Francisco, California, United States
• University of Miami — Miami, Florida, United States
• Emory University — Atlanta, Georgia, United States
• Northwestern University — Chicago, Illinois, United States
• University of Illinois, Chicago — Chicago, Illinois, United States
• University of Minnesota — Minneapolis, Minnesota, United States
• University of Pennsylvania — Philadelphia, Pennsylvania, United States
• University of Alberta — Edmonton, Alberta, Canada

Full record on ClinicalTrials.gov

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