Reduced Fear of Hypoglycemia in Successful Islet Transplantation
- Jeffrey A. Johnson, PHD12,
- Maria Kotovych, MA2,
- Edmond A. Ryan, MD, FRCPC34 and
- A.M. James Shapiro, MBBS, BMEDSCI, PHD, FRCSC45
- 1Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- 2Institute of Health Economics, Edmonton, Alberta, Canada
- 3Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- 4Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada
- 5Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
- Address correspondence to Jeffrey A. Johnson, PhD, Institute of Health Economics, 1200-10405 Jasper Ave., Edmonton, Alberta, Canada T5J 3N4. E-mail: jeff.johnson{at}ualberta.ca
The recent dramatic improvement in clinical outcomes in islet transplantation in type 1 diabetes with the Edmonton Protocol has led to considerable excitement in the field of diabetes (1,2). The unprecedented 1-year success rates provide considerable evidence of the clinical effectiveness of the procedure (2,3). However, the benefits of freeing or reducing insulin requirements for these patients must be weighed against the risks of the procedure itself, as well as the life-long immunosuppression. Before making this treatment available to a larger number of people with type 1 diabetes, measures of quality of care and of clinical effectiveness must be incorporated to fully evaluate the benefit of this treatment.
Episodes of severe hypoglycemia, a common occurrence in patients with labile type 1 diabetes and hypoglycemia unawareness, result in considerable fear and anxiety (4 …
