Posttransplant diabetes mellitus after pancreas transplantation

P. G. Dean, Y. C. Kudva, T. S. Larson, W. K. Kremers, M. D. Stegall

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Some patients do not achieve normoglycemia after an otherwise successful pancreas transplant. The aim of this study was to define the incidence and risk factors for the development of persistent diabetes mellitus after pancreas transplantation. We studied the outcomes of 144 pancreas transplants performed at our institution between January 2001 and December 2005. Diabetes mellitus was defined as the persistent need for pharmacologic treatment of diabetes mellitus despite evidence of allograft function. Data are expressed as median (25-75% inter-quartile range). Median follow-up was 39 months (IQR 26-55 months). During the follow-up period, 28 patients (19%) developed diabetes mellitus with a functioning allograft. Factors predicting hyperglycemia included: pretransplant insulin dose, BMI and acute rejection episodes (p < 0.0001, p = 0.0002 and p < 0.02, respectively). The median pretransplant hemoglobin A1c for patients developing diabetes was 8.3% (IQR 7.0-9.4%) compared to 6.2% (IQR 5.8-7.4%) at 2 years after transplant (p = 0.0069). In conclusion, persistent diabetes mellitus can occur despite the presence of a functioning pancreas allograft and is due to increased pretransplant BMI, high pretransplant insulin requirements and episodes of acute rejection.

Original languageEnglish (US)
Pages (from-to)175-182
Number of pages8
JournalAmerican Journal of Transplantation
Volume8
Issue number1
DOIs
StatePublished - Jan 1 2008

Keywords

  • Clinical pancreas transplantation
  • Complications
  • Type 1 diabetes mellitus
  • Type 2 diabetes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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