Spontaneous hypoglycaemia after pancreas transplantation in Type 1 diabetes mellitus

Diabet Med. 1998 Dec;15(12):991-6. doi: 10.1002/(SICI)1096-9136(1998120)15:12<991::AID-DIA717>3.0.CO;2-Q.

Abstract

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 < or = 3.0 mmol l(-1)) in the profiles, both postprandial and postabsorptive, whereas none of CON-Tx did (p < 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • C-Peptide / blood
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / surgery*
  • Diabetic Nephropathies / surgery
  • Female
  • Humans
  • Hypoglycemia / etiology*
  • Insulin / blood*
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / physiology
  • Liver Transplantation / physiology
  • Male
  • Pancreas Transplantation / physiology*
  • Postoperative Complications*
  • Time Factors

Substances

  • Blood Glucose
  • C-Peptide
  • Insulin