Trial Comparing Metabolic Efficiency of Islet Graft to Intensive Insulin Therapy for Type 1 Diabetes's Treatment

Inclusion Criteria

• •Patient with type 1 diabetes or C-peptide negative diabetes Diabetes duration \> 5 years
• •No residual insulin secretion (plasmatic basal and stimulated C-peptide \< 0.3 ng/ml)
• •HbA1c considered acceptable by the selection committee
• •Insulin needs \< 0.85 IU/kg/day
• •Islet cell infusion after kidney graft
• •* Patient with terminal renal failure and functional kidney graft for at least 6 months (creatinine clearance greater than or equal to 35 ml/min)
• •* Patient whose glycaemic control obtained with insulin therapy could threaten kidney graft survival and/or significantly alter quality of life. This situation is assessed by a diabetologist
• •Islet cell infusion only: patient with major glycaemic variability despite proper intensive insulin therapy, closely monitored by a diabetologist. Poor glucose control, assessed by a diabetologist, endangers the patient's life and/or significantly alters personal, social, professional and family quality of life. At least one of these criteria must be fulfilled :
• •* Hypoglycaemia unawareness, blood glucose level \< 3mmol/L or 0.54 mg/L
• •* At least 2 severe hypoglycaemia events (defined by the necessity of a third party's assistance) per year or a ketoacidosis requiring patient's hospitalization during the last year.
• •* Impairment of quality of life or life-threat for patient or other persons, or progressive complications despite optimal insulin therapy
• •Social Security membership or benefit from Social Welfare