TY - JOUR
T1 - Spontaneous hypoglycaemia after pancreas transplantation in type 1 diabetes mellitus
AU - Battezzati, A.
AU - Bonfatti, D.
AU - Benedini, S.
AU - Calori, G.
AU - Caldara, R.
AU - Mazzaferro, V.
AU - Elli, A.
AU - Secchi, A.
AU - Di Carlo, V.
AU - Pozza, G.
AU - Luzi, L.
PY - 1998
Y1 - 1998
N2 - Hypoglycaemia is an important complication of insulin treatment in Type 1 diabetes mellitus (DM). Pancreas transplantation couples glucose sensing and insulin secretion, attaining a distinctive advantage over insulin treatment. We tested whether successful transplantation can avoid hypoglycaemia in Type 1 DM. Combined kidney and pancreas transplanted Type 1 DM who complied with good function criteria (KP-Tx, n = 55), and isolated kidney or liver transplanted non-diabetic subjects on the same immunosuppressive regimen (CON-Tx, n = 14), underwent 1-day metabolic profiles in the first 3 years after transplantation, sampling plasma glucose (PG) and pancreatic hormones every 2 hours. KP-Tx had lower PG than CON-Tx in the night and in the morning and higher insulin concentrations throughout the day. KP-Tx had lower PG nadirs than CON-Tx (4.40 ± 0.05 vs 4.96 ± 0.16 mmol 1-1, ANOVA ρ = 0.001). Nine per cent of KP-Tx had hypoglycaemic values (PG ≤3.0 mmol l-1) in the profiles, both postprandial and postabsorptive, whereas none of CON-Tx did (p <0.02). In conclusion, after pancreas transplantation, mild hypoglycaemia is frequent, although its clinical impact is limited. Compared to insulin treatment in Type 1 DM, pancreas transplantation improves but cannot eliminate hypoglycaemia.
AB - Hypoglycaemia is an important complication of insulin treatment in Type 1 diabetes mellitus (DM). Pancreas transplantation couples glucose sensing and insulin secretion, attaining a distinctive advantage over insulin treatment. We tested whether successful transplantation can avoid hypoglycaemia in Type 1 DM. Combined kidney and pancreas transplanted Type 1 DM who complied with good function criteria (KP-Tx, n = 55), and isolated kidney or liver transplanted non-diabetic subjects on the same immunosuppressive regimen (CON-Tx, n = 14), underwent 1-day metabolic profiles in the first 3 years after transplantation, sampling plasma glucose (PG) and pancreatic hormones every 2 hours. KP-Tx had lower PG than CON-Tx in the night and in the morning and higher insulin concentrations throughout the day. KP-Tx had lower PG nadirs than CON-Tx (4.40 ± 0.05 vs 4.96 ± 0.16 mmol 1-1, ANOVA ρ = 0.001). Nine per cent of KP-Tx had hypoglycaemic values (PG ≤3.0 mmol l-1) in the profiles, both postprandial and postabsorptive, whereas none of CON-Tx did (p <0.02). In conclusion, after pancreas transplantation, mild hypoglycaemia is frequent, although its clinical impact is limited. Compared to insulin treatment in Type 1 DM, pancreas transplantation improves but cannot eliminate hypoglycaemia.
KW - Blood glucose
KW - Hypoglycaemia
KW - Insulin
KW - Pancreas transplantation
KW - Type 1 diabetes mellitus
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U2 - 10.1002/(SICI)1096-9136(1998120)15:12<991::AID-DIA717>3.0.CO;2-Q
DO - 10.1002/(SICI)1096-9136(1998120)15:12<991::AID-DIA717>3.0.CO;2-Q
M3 - Article
C2 - 9868970
AN - SCOPUS:14444272509
VL - 15
SP - 991
EP - 996
JO - Diabetic Medicine
JF - Diabetic Medicine
SN - 0742-3071
IS - 12
ER -