Prediction of the long-term metabolic success of the pancreatic graft function

Alberto Battezzati, Stefano Benedini, Rossana Caldara, Giliola Calori, Antonio Secchi, Guido Pozza, Livio Luzi

Research output: Contribution to journalArticle

Abstract

Background. Strategies to prevent the return to the diabetic state for graft loss or failure or any other cause after pancreas transplantation require the identification of the subjects at risk. This study evaluated whether daily glucose, insulin, and c-peptide profiles and studies of insulin sensitivity and secretion after transplantation predict pancreatic graft failure. Methods. Fifty-three subjects with type 1 diabetes with end-stage renal failure who received a combined pancreas and kidney transplant underwent the following procedures 1 year after transplantation: 1-day metabolic profiles, sampling every 2 hours for plasma glucose, serum insulin, and c-peptide (n=51); an intravenous glucose tolerance test (IVGTT) to evaluate insulin secretion (n=48); and an euglycemic insulin clamp to evaluate insulin sensitivity (M value, n=14). The recipients were then followed up to 8 years (mean follow-up 4.8±0.3 years) to evaluate the return to the diabetic state. Results. Survival analysis showed that plasma glucose in the profiles and insulin secretion in IVGTT were strongly related to the risk of returning to the diabetic state. A cutoff value of mean daily plasma glucose > 127 mg/dL, corresponding to the top quartile of the mean plasma glucose distribution in the profiles, predicted the return to the diabetic state within 4 years from transplantation with a 93% specificity and a 100% sensitivity. A cutoff value of insulin delta peak

Original languageEnglish
Pages (from-to)1560-1565
Number of pages6
JournalTransplantation
Volume71
Issue number11
Publication statusPublished - Jun 15 2001

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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