Rydzon B, et al. - The authors aimed to examine the long-term changes in insulin sensitivity (IS), and associated factors such as patient characteristics, transplant factors, clinical management, and IS-related biomarkers are unknown. As per findings, IS measured by Simple Index of Insulin Sensitivity (SI_is) improved several years following transplant. On the other hand, IS measured by Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) did not worsen. An improvement could be noted in IS due to higher exenatide dose, more islets transplanted, and diet and exercise (lowering leptin and RANKL). This possibly enhanced glycemic control and lower metabolic demand on transplanted islets.