Sequential metabolic studies of pancreas allograft function in type 1 diabetic recipients.
We have previously shown that the loss of acute first phase insulin secretion precedes pancreas allograft rejection and development of glucose intolerance in Type 1 diabetic patients. In order to examine whether there is a progressive loss of phases of insulin secretion and beta-cell function in technically successful pancreas transplants during the first year, we measured glucose, insulin, and C-peptide responses to physiological (mixed meal) and pharmacological (IV glucose and IV glucagon) stimulation in 27 glucose-tolerant, insulin-independent allograft recipients at 3, 6, and 12 months. Mean +/- SE fasting serum glucose levels were normalized throughout the study period. Postprandial serum glucose profiles tended to increase by 12 months compared to 3 and 6 months, although peak glucose levels were not statistically different. Following pancreas transplantation, basal serum insulin levels were high at 3 months (163 +/- 17 pM), 6 months (165 +/- 22 pM), and 12 months (248 +/- 54 pM, p = NS) in the Type 1 diabetic pancreas allograft recipients when compared to normal (25 +/- 3 pM). We observed slight elevations in postprandial insulin and C-peptide profiles at 12 months compared to 3 and 6 months. Following IV glucose and glucagon stimulation, serum insulin and C-peptide levels as well as phases of insulin release did not differ over the 12-month study period. Similarly, the glucose decay constant (KG) was nearly identical at 3, 6, and 12 months. In summary, 1 year following successful whole cadaveric, heterotopic pancreas transplantation in Type 1 diabetic recipients, fasting serum glucose remains normalized, while postprandial glucose tends to rise.(ABSTRACT TRUNCATED AT 250 WORDS)
Cottrell
D A
DA
Department of Medicine, Ohio State University Hospitals, Columbus.
Henry
M L
ML
O'Dorisio
T M
TM
Tesi
R J
RJ
Ferguson
R M
RM
Osei
K
K
D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery; D004435:Eating; D005260:Female; D005500:Follow-Up Studies; D005934:Glucagon; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D016030:Kidney Transplantation; D008297:Male; D016035:Pancreas Transplantation / Q000502:physiology*; D012044:Regression Analysis; D014184:Transplantation, Homologous
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D005934:Glucagon