Patient perceptions of islet transplantation for type 1 diabetes

Objective: To determine the demand for islet transplantation among patients with type 1 diabetes. Methods: Surveys were mailed to patients with type 1 diabetes at 2 centres: 1 with an islet transplantation program (Vancouver, British Columbia) and another without a program (Halifax, Nova Scotia). The primary outcome was patient acceptance of islet transplantation after learning about the risks and benefits. Results: Of the 588 responses from a sample of 1499, 451 (76.7%) would accept or probably accept islet transplantation. Most common reasons for acceptance were 1) fewer diabetes-related complications (92.7%); 2) decreased hypoglycemia (78.5%); and 3) no insulin injections (75.0%). The rest, 137 (23.3%) respondents, would not or probably not accept islet transplantation because of 1) immunosuppressant medications (90.6%); 2) risks not yet identified (58.8%). Most would not consider islet transplantation a failure if insulin was required post-transplant (71%). Acceptance was higher among those who were younger and had less formal education and a lower household income. Patients who would accept islet transplantation had higher glycated hemoglobin, used higher doses of insulin and had worse perceived diabetes control and general health. Conclusions: The majority of patients with type 1 diabetes surveyed for this study would accept islet transplantation, with expectations of fewer complications, decreased hypoglycemia and freedom from insulin.