Risk of glucose intolerance and diabetes in hemipancreatectomized donors selected for normal preoperative glucose metabolism.
OBJECTIVE
Hemipancreatectomy (HPx) for the purpose of organ donation has been associated with a 25% risk of developing abnormal glucose tolerance or diabetes in the year after surgery. Since 1997, the University of Minnesota has imposed criteria to prevent potential donors with clinical features associated with an increased diabetes risk from undergoing HPx. We recently assessed glucose tolerance in hemipancreatectomized donors selected since the adoption of the new criteria to determine whether the risk of developing abnormal glucose tolerance was reduced below the 25% rate previously demonstrated.


METHODS
Individuals who underwent HPx for the purpose of pancreas donation between 1997 and 2003 were contacted and interviewed about their health status. Those not taking diabetes medications were invited to undergo an assessment of their glucose tolerance.


RESULTS
Successful contact was made with 15 of 21 donors who underwent HPx during this period. Two donors reported use of oral diabetic medications and were not studied further. Of the remaining 13, 2 had impaired fasting glucose (fasting blood glucose 100-125 mg/dl), 1 had impaired glucose tolerance (2-h postglucose load blood glucose 140-199 mg/dl), and 3 displayed both. One donor met the diagnostic criteria for diabetes. Six donors had normal glucose values.


CONCLUSIONS
Despite the use of stringent criteria to exclude those at risk for developing abnormalities in glucose metabolism, 43% of healthy humans who underwent HPx between 1997 and 2003 have impaired fasting glucose, impaired glucose tolerance, or diabetes on follow-up. The current preoperative criteria are insufficient to predict those who will develop abnormal glucose metabolism after HPx.
Kumar
Anjali F
AF
Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA. kumar045@umn.edu
Gruessner
Rainer W G
RW
Seaquist
Elizabeth R
ER
D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D018149:Glucose Intolerance / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D019520:Living Donors; D016035:Pancreas Transplantation; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D018579:Patient Selection; D011300:Preoperative Care; D012016:Reference Values; D018570:Risk Assessment
D001786:Blood Glucose; D007004:Hypoglycemic Agents