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Previous Volume 358:1969-1972 May 1, 2008 Number 18 Next

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To the Editor: Seven years after receiving a kidney transplant, a 44-year old woman with a 31-year history of type 1 diabetes mellitus and long-term complications (retinopathy, neuropathy, and end-stage renal disease) underwent an allogeneic islet-after-kidney transplantation with the use of a modified Edmonton protocol.¹ Islet-graft dysfunction with preserved C-peptide levels was observed after approximately 1 year. After the patient had provided written informed consent, off-label use of exenatide (Byetta, Amylin Pharmaceuticals) (10 µg, administered subcutaneously twice daily) was initiated 19 months after the islet transplantation in order to improve glucose control (ClinicalTrials.gov number, NCT00315588 [ClinicalTrials.gov] ).² Exenatide treatment resulted . . . [Full Text of this Article]

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