Patient Perceptions of Islet Transplantation for Type 1 Diabetes

• Published in: Canadian journal of diabetes Vol. 34; no. 3; pp. 203 - 210
• Main Authors: Fung, Michelle A., MD, Barts, Agnieszka, MD, Thompson, David M., MD, Ransom, Thomas P.P., MD, Elliott, Tom G., MD, Sirrs, Sandra M., MD, Ur, Ehud, MD
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 2010
• Subjects: diabete de type 1; Endocrinology & Metabolism; greffe dllots de Langerhans; islet transplant; Other; questionnaire; survey; type 1 diabetes; greffe dllots de Langerhans; diabete de type 1; survey; type 1 diabetes; questionnaire; islet transplant
• ISSN: 1499-2671; 2352-3840
• DOI: 10.1016/S1499-2671(10)43008-7

ABSTRACT OBJECTIVE To determine the demand for islet transplantation among patients with type 1 diabetes. METHODS Surveys were mailed to patients with type 1 diabetes at 2 centres: 1 with an islet transplantation program (Vancouver, British Columbia) and another without a program (Halifax, Nova Scotia). The primary outcome was patient acceptance of islet transplantation after learning about the risks and benefits. RESULTS Of the 588 responses from a sample of 1499, 451 (76.7%) would accept or probably accept islet transplantation. Most common reasons for acceptance were 1) fewer diabetes-related complications (92.7%); 2) decreased hypoglycemia (78.5%); and 3) no insulin injections (75.0%). The rest, 137 (23.3%) respondents, would not or probably not accept islet transplantation because of 1) immunosuppressant medications (90.6%); 2) risks not yet identified (58.8%). Most would not consider islet transplantation a failure if insulin was required post-transplant (71%). Acceptance was higher among those who were younger and had less formal education and a lower household income. Patients who would accept islet transplantation had higher glycated hemoglobin, used higher doses of insulin and had worse perceived diabetes control and general health. CONCLUSIONS The majority of patients with type 1 diabetes surveyed for this study would accept islet transplantation, with expectations of fewer complications, decreased hypoglycemia and freedom from insulin.