Spontaneous hypoglycaemia after pancreas transplantation in type 1 diabetes mellitus

A. Battezzati, D. Bonfatti, S. Benedini, G. Calori, R. Caldara, V. Mazzaferro, A. Elli, A. Secchi, V. Di Carlo, G. Pozza, L. Luzi

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)991-996
Number of pages6
JournalDiabetic Medicine
Volume15
Issue number12
DOIs
Publication statusPublished - 1998

Keywords

  • Blood glucose
  • Hypoglycaemia
  • Insulin
  • Pancreas transplantation
  • Type 1 diabetes mellitus

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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