Spontaneous hypoglycaemia after pancreas transplantation in Type 1 diabetes mellitus

✍ Scribed by Battezzati, A.; Bonfatti, D.; Benedini, S.; Calori, G.; Caldara, R.; Mazzaferro, V.; Elli, A.; Secchi, A.; Carlo, V. Di; Pozza, G.; Luzi, L.

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 95 KB
• Volume: 15
• Category: Article
• ISSN: 0742-3071
• DOI: 10.1002/(sici)1096-9136(1998120)15:12<991::aid-dia717>3.0.co;2-q

✦ Synopsis

Hypoglycaemia is an important complication of insulin treatment in

Type 1 diabetes mellitus (DM). Pancreas transplantation couples glucose sensing and insulin secretion, attaining a distinctive advantage over insulin treatment. We tested whether successful transplantation can avoid hypoglycaemia in Type 1 DM. Combined kidney and pancreas transplanted Type 1 DM who complied with good function criteria (KP-Tx, n ‫؍‬ 55), and isolated kidney or liver transplanted non-diabetic subjects on the same immunosuppressive regimen (CON-Tx, n ‫؍‬ 14), underwent 1-day metabolic profiles in the first 3 years after transplantation, sampling plasma glucose (PG) and pancreatic hormones every 2 hours. KP-Tx had lower PG than CON-Tx in the night and in the morning and higher insulin concentrations throughout the day. KP-Tx had lower PG nadirs than CON-Tx (4.40 ؎ 0.05 vs 4.96 ؎ 0.16 mmol l ؊1 , ANOVA p ‫؍‬ 0.001). Nine per cent of KP-Tx had hypoglycaemic values (PG Յ3.0 mmol l ؊1 ) in the profiles, both postprandial and postabsorptive, whereas none of CON-Tx did (p Ͻ 0.02). In conclusion, after pancreas transplantation, mild hypoglycaemia is frequent, although its clinical impact is limited. Compared to insulin treatment in Type 1 DM, pancreas transplantation improves but cannot eliminate hypoglycaemia.