Long-term metabolic control in recipients of combined pancreas and kidney transplants.
Metabolic glucose control was followed in 36 patients at 12-month intervals for up to 5 years after a successful combined kidney and segmental duct-occluded pancreas transplantation. All recipients had normal blood glucose levels at each examination. HbA1 values, intravenous glucose tolerance test, C-peptide levels and C-peptide responses to glucagon stimulation were also, on average, within the normal range. Several individual patients had, however, abnormal values for these parameters. At most 46% had abnormal values for HbA1 and intravenous glucose tolerance test, up to 13% showed low C-peptide values and up to 46% of the stimulated C-peptide responses were inadequate at the different intervals. These parameters did not deteriorate with time. This was true both for the whole group of patients as well as for the 6 patients with a 5-year observation time evaluated separately. Despite these abnormalities in glucose metabolism, all patients remained normoglycaemic without need for exogenous insulin up to 5 years after transplantation. The long-term ability of duct-occluded segmental pancreatic grafts to preserve euglycaemia therefore seems to remain intact at least for 5 years.
Department of Internal Medicine, National Hospital, University of Oslo, Norway.
H
H
Holdaas
I B
IB
Brekke
A
A
Hartmann
O H
OH
Bentdal
T
T
Ganes
A
A
Gjellestad
P
P
Fauchald
K J
KJ
Berg
O
O
Djøseland
J
J
Jervell
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000601:surgery*; D005500:Follow-Up Studies; D005934:Glucagon; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000502:physiology*; D016035:Pancreas Transplantation / Q000502:physiology*; D012016:Reference Values; D014511:Uremia / Q000601:surgery*
D001786:Blood Glucose; D002096:C-Peptide; D005934:Glucagon; D006442:Glycated Hemoglobin; D007166:Immunosuppressive Agents