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ORIGINAL ARTICLE
Year : 2014  |  Volume : 18  |  Issue : 6  |  Page : 838-845

Efficacy and safety of autologous bone marrow derived hematopoietic stem cell transplantation in patients with type 2 DM: A 15 months follow-up study


1 Department of Endocrinology, Post Graduate Institute of Medical Research and Education, Chandigarh, India
2 Department of Radiodiagnosis, Post Graduate Institute of Medical Research and Education, Chandigarh, India
3 Department of Transfusion Medicine, Post Graduate Institute of Medical Research and Education, Chandigarh, India
4 Department of Psychiatry, Post Graduate Institute of Medical Research and Education, Chandigarh, India

Correspondence Address:
Dr. Anil Bhansali
Department of Endocrinology, Post Graduate Institute of Medical Research and Education, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.140257

Clinical trial registration NCT00644241

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Background: there are dearths of studies describing the effect of autologous bone marrow derived stem cell transplantation (ABMSCT) through targeted approach in Type 2 Diabetes Mellitus.This study reports the efficacy and safety of super-selective injection of ABMSCT in T2DM. Materials and Methods: Ten patients (8 men and 2 women) with T2DM, with duration of disease >5 years and with documented triple drug failure receiving insulin (0.7 U/Kg/day), metformin and pioglitazone underwent super-selective injection of stem cells into superior pancreaticoduodenal artery under fluoroscopic guidance. The primary outcome measure was decrease in insulin requirement by ≥50% (defined as responders), while secondary endpoints were improvement in glucagon stimulated C-peptide levels, changes in weight, HbA1c, lipid profile and quality of life (QOL) at the end of 15 months. Results: Six patients (60%) were 'responders' at 15 months of follow-up showing a reduction in mean insulin requirement by 74% as compared to baseline and one patient was off-insulin till the end of the study. Mean HbA1c reduction in 'responders' was 1.1% (8.1 ± 0.5% to 7.0 ± 0.6%, P = 0.03), accompanied with a significant improvement in glucagon stimulated C-peptide levels (P = 0.03), Homeostasis Model Assessment -β (P = 0.03) and QOL scores. However, 'non-responders' did not show any significant alterations in these parameters. No serious adverse events were noted. Conclusion: Our observations indicate that ABMSCT is effective in management of T2DM and its efficacy is maintained over a period of 15 months without any adverse events. However, more number of patients and longer duration of follow-up are required to substantiate these observations.


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