Patient description: The patient is a 32-year-old obese woman who came to the clinic with weight concerns. She is 165 cm tall and her weight is 113 kg. She is complaining of sleep apnea, PCO and dissatisfaction with her body shape. She is a high-school teacher married for 5 years. She doesn't use any contraceptive methods for the past 4 months and she had no prior pregnancies. She doesn't smoke or use any drugs. She likes to try diets and exercise to lose weight. She completed the four square step test in 14 seconds. Her BP: 130/80, HR: 195/min and her BMI is: 41.54. Her labs: FBS: 98 mg/dl TG: 150 mg/dl Cholesterol: 180 mg/dl LDL: 90 mg/dl HDL: 35 mg/dl Her cardiac assessment is normal. Her joints and ROM are within normal.

Clinical trial eligibility criteria: eligible ages (years): 18.0-65.0,  Type 1 Diabetes Hypoglycemia Primary islet allotransplant 2. Type 1 diabetes mellitus, complicated by at least one of the following situations that persist despite intensive efforts in close cooperation with their diabetes care team: 1. Metabolic lability/instability; 2. Reduced awareness of hypoglycemia; 3. Persistently poor glucose control (as defined by HgbA1c>10% at the end of six months of intensive management efforts with the diabetes care team); 4. Progressive secondary complications. 3. Age 18 and older 4. Able to give written informed consent  Age less than 18 years 2. Body weight greater than75 kg. 3. BMI greater than 26 kg/m2 for male and females 4. Waist-to-hip ratio 0.80 (female) and 0.95 (male) 5. First degree relative with type 2 diabetes 6. Insulin requirement of greater than 0.7 IU/kg/day 7. HbA1C greater than 12% 8. Positive C-peptide response to intravenous arginine stimulation 9. Untreated proliferative retinopathy 10. Macroalbuminuria (urinary albumin excretion greater than 300 mg/24hrs) 11. Creatinine clearance greater than 85 ml/min/1.73 m2 in females, greater than 95 ml/min/1.73 m2 in males 12. Serum creatinine greater than 1.2 mg/dl 13. Previous pancreas or islet transplant 14. Previous OKT3 antibody therapy 15. Presence of history of panel-reactive anti-HLA antibodies greater than 10% 16. Abnormal T4 and TSH despite thyroid replacement therapy 17. Positive pregnancy test, or presently breast-feeding 18. Active infection 19. Negative screen for Epstein-Barr Virus (EBV) by an EBNA method 20. Invasive aspergillus infection within year prior to study entry 21. Any history of malignancy 22. Active alcohol or substance abuse 23. History of non-adherence to prescribed regimens 24. Psychiatric disorder making the subject not a suitable candidate for transplantation 25. Karnofsky performance score greater than 70 26. Baseline Hgb greater than 11.7 g/dl; lymphopenia (greater than 1,000/L), or leukopenia (greater than 4,000 total leukocytes/L), or an absolute CD4+ count <500/L 27. Thrombocytopenia greater than 150 x 109/L 28. Use of warfarin or other anticoagulant therapy (except aspirin) or patient with PT-INR greater than 1.5 29. Severe co-existing cardiac disease 30. Baseline liver function tests outside of normal range 31. Presence of gallstones on baseline ultrasound exam 32. Active peptic ulcer disease 33. Severe unremitting diarrhea or other gastrointestinal disorders potentially interfering with the ability to absorb oral medications 34. Celiac disease 35. Hyperlipidemia (fasting LDL cholesterol greater than 130 mg/dl, treated or untreated; and/or fasting triglycerides greater than 200 mg/dl) 36. Addison's disease. 37. Under treatment for a medical condition requiring chronic use of systemic steroids 38. Any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the trial