Islet Transplantation for Type 1 Diabetes Mellitus

Inclusion Criteria

• •Duration of diabetes: 5 years or more
• •Type 1 diabetes with C-peptide \< 200 pmol/L and a simultaneous plasma glucose between 60 and 250 mg/dl
• •Complex insulin program supervised by an endocrinologist for at least 6 months
• •Hypoglycemic unawareness diagnosed using Clarke Awareness Questionnaire
• •Body weight \< 70 kg
• •Body Mass Index \< 30 kg/m\^2
• •Insulin requirement \< 40 units/day by multiple daily injections or \< 30 units /day by external insulin pump or \< 0.6 unit/kg/day with a HbA1c \< 7.0 % ( Normal \< 6 %)
• •No overt cardiovascular disease
• •No laser treatment for retinopathy
• •Retinopathy diagnosed by ophthalmologist to be stable and requiring no further evaluation for at least one year
• •Women of child bearing age will have a negative pregnancy test at screening and time of trial initiation
• •Women enrolled in the trial should be willing to practice birth control while on immunosuppression
• •No psychologic issues that would interfere with adherence to safe clinical practice
• •Blood type (ABO) compatibility
• •No evidence of chronic liver disease (aspartate aminotransferase (AST) \< 2.5 times normal, alanine aminotransferase (ALT) \< 2.5 times normal, international normalized ratio (INR) \< 1.4, No evidence of fatty liver on abdominal ultrasound.