PMID- 19686048
OWN - NLM
STAT- MEDLINE
DCOM- 20100217
LR  - 20220408
IS  - 1557-8534 (Electronic)
IS  - 1547-3287 (Linking)
VI  - 18
IP  - 10
DP  - 2009 Dec
TI  - Efficacy of autologous bone marrow-derived stem cell transplantation in patients 
      with type 2 diabetes mellitus.
PG  - 1407-16
LID - 10.1089/scd.2009.0164 [doi]
AB  - Progressive and inexorable beta-cell dysfunction is the hallmark of type 2 
      diabetes mellitus (T2DM) and beta-cell regeneration using stem cell therapy may 
      prove to be an effective modality. A total of 10 patients (8 men) with T2DM for 
      >5 years, failure of triple oral antidiabetic drugs, currently on insulin (> or = 
      0.7 U/kg/day) at least for 1 year, and glutamic acid decarboxylase antibody 
      negative were included. Patients on stable doses of medications for past 3 months 
      were recruited. Primary end points were reduction in insulin requirement by > or 
      = 50% and improvement in glucagon-stimulated C-peptide levels at the end of 6 
      months of autologous bone marrow-derived stem cell transplantation (SCT), while 
      secondary end points were a change in weight and HbA1c and lipid levels as 
      compared to baseline. Seven patients were responders and showed a reduction in 
      insulin requirement by 75% as compared to baseline. Mean duration to achieve the 
      primary objective was 48 days. Three patients were able to discontinue insulin 
      completely, although it was short-lived in one. Mean HbA1c reduction was 1% and 3 
      of the 7 responders had HbA1c value <7%. A significant weight loss of 5.5 kg was 
      noted in the responders, whereas, nonresponders gained 2.2 kg of weight. However, 
      weight loss did not correlate with reduction in insulin requirement (r = 0.68, P 
      = 0.06). There was a significant improvement in both fasting and 
      glucagon-stimulated C-peptide level in the group (P = 0.03) and responders (P = 
      0.03). HOMA-B increased significantly in the whole group (P = 0.02) and 
      responders (P = 0.04) whereas, HOMA-IR did not change significantly (P = 0.74). 
      Reduction in insulin doses correlated with stimulated C-peptide response at the 
      baseline (r = 0.83, P = 0.047) and mononuclear cell count of infused stem cells 
      (r = 0.57, P = 0.04). No serious adverse effects were noted. Our observations 
      indicate that SCT is a safe and effective modality of treatment to improve 
      beta-cell function in patients with T2DM. However, further large-scale studies 
      are needed to substantiate these observations.
FAU - Bhansali, Anil
AU  - Bhansali A
AD  - Department of Endocrinology, Post Graduate Institute of Medical Research and 
      Education, Chandigarh, India. anilbhansali_endocrine@rediffmail.com
FAU - Upreti, Vimal
AU  - Upreti V
FAU - Khandelwal, N
AU  - Khandelwal N
FAU - Marwaha, N
AU  - Marwaha N
FAU - Gupta, Vivek
AU  - Gupta V
FAU - Sachdeva, Naresh
AU  - Sachdeva N
FAU - Sharma, R R
AU  - Sharma RR
FAU - Saluja, Karan
AU  - Saluja K
FAU - Dutta, Pinaki
AU  - Dutta P
FAU - Walia, Rama
AU  - Walia R
FAU - Minz, Ranjana
AU  - Minz R
FAU - Bhadada, Sanjay
AU  - Bhadada S
FAU - Das, Sambit
AU  - Das S
FAU - Ramakrishnan, Santosh
AU  - Ramakrishnan S
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Stem Cells Dev
JT  - Stem cells and development
JID - 101197107
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Glucose/metabolism
MH  - Bone Marrow Cells/*cytology
MH  - Diabetes Mellitus, Type 2/blood/*therapy
MH  - Fasting/blood
MH  - Female
MH  - Humans
MH  - Insulin/metabolism
MH  - Male
MH  - Middle Aged
MH  - *Stem Cell Transplantation/adverse effects
MH  - Transplantation, Autologous
MH  - Treatment Outcome
EDAT- 2009/08/19 09:00
MHDA- 2010/02/18 06:00
CRDT- 2009/08/19 09:00
PHST- 2009/08/19 09:00 [entrez]
PHST- 2009/08/19 09:00 [pubmed]
PHST- 2010/02/18 06:00 [medline]
AID - 10.1089/scd.2009.0164 [doi]
PST - ppublish
SO  - Stem Cells Dev. 2009 Dec;18(10):1407-16. doi: 10.1089/scd.2009.0164.