title: Metabolic surgery for the treatment of type 2 diabetes in pancreas after kidney transplant candidates.
abstract: Metabolic surgery for the treatment of type 2 diabetes mellitus (T2DM) in patients not morbidly obese (BMI <35) has been widely studied. Taking into account that ∼12% of pancreas transplants are performed in patients with T2DM, our goal was to evaluate the impact of metabolic surgery on the management of obese patients with T2DM on waiting lists for a pancreas transplant. We performed a Roux-en-Y gastrointestinal bypass in 5 patients with insulin-dependent T2DM who were candidates for pancreas after kidney transplant and with a BMI <35. Three patients became insulin independent by the end of the first year while the other 2 reduced their insulin requirements by 70%. Furthermore, all patients achieved improved control of lipid levels. We concluded that the surgery was effective in controlling blood glucose and lipid metabolism in these obese T2DM kidney transplant recipients. In this population, a pancreas transplant, along with its associated morbidity, may be avoided.
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; General and Digestive Tract Surgery Service, São Lucas Hospital-PUCRS, Porto Alegre, Brazil.
authors.forename: S
authors.initials: S
authors.lastname: Gullo-Neto
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; General and Digestive Tract Surgery Service, São Lucas Hospital-PUCRS, Porto Alegre, Brazil.
authors.forename: A Vontobel
authors.initials: AV
authors.lastname: Padoin
authors.affiliation: General and Digestive Tract Surgery Service, São Lucas Hospital-PUCRS, Porto Alegre, Brazil.
authors.forename: J E
authors.initials: JE
authors.lastname: Queiroz de Carvalho
authors.affiliation: Anesthesiology Service, São Lucas Hospital-PUCRS, Porto Alegre, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Wendling
authors.affiliation: Nephrology Service, São Lucas Hospital-PUCRS, Porto Alegre, Brazil.
authors.forename: M A
authors.initials: MA
authors.lastname: Traesel
authors.affiliation: Nephrology Service, São Lucas Hospital-PUCRS, Porto Alegre, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Kroth
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: C
authors.initials: C
authors.lastname: Miranda
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: A Colombo
authors.initials: AC
authors.lastname: Balestro
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Siqueira
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: B
authors.initials: B
authors.lastname: Chao Lisot
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: S
authors.initials: S
authors.lastname: Lima
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; General and Digestive Tract Surgery Service, São Lucas Hospital-PUCRS, Porto Alegre, Brazil.
authors.forename: C Corá
authors.initials: CC
authors.lastname: Mottin
authors.affiliation: Medical School of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Nephrology Service, São Lucas Hospital-PUCRS, Porto Alegre, Brazil. Electronic address: dsaitov@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Saitovitch
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides