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Microvascular Complications in Type 1 Diabetes: A Comparative Analysis of Patients Treated with Autologous Nonmyeloablative Hematopoietic Stem-Cell Transplantation and Conventional Medical Therapy

2017; Frontiers Media; Volume: 8; Linguagem: Inglês

10.3389/fendo.2017.00331

ISSN

1664-2392

Autores

Jaquellyne Gurgel Penaforte-Saboia, Renan Magalhães Montenegro, Carlos Eduardo Barra Couri, Lívia Aline de Araújo Batista, Ana Paula Dias Rangel Montenegro, Virgínia Oliveira Fernandes, Akhtar Hussain, Carlos Antônio Negrato, Kelen Cristina Ribeiro Malmegrim, Daniela A. Moraes, Juliana Bernardes Elias Dias, Belinda Pinto Simões, Marília Brito Gomes, Maria Carolina Oliveira,

Tópico(s)

Diabetes Management and Research

Resumo

To 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).Cross-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.After 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.Patients 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.

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