Glucose Homeostasis and Insulin Secretion in Human Recipients of Pancreas Transplantation

Abstract

To ascertain the consequences of pancreas transplantation with systemic venous drainage on glucose homeostasis and insulin secretion, glucose and insulin responses to intravenous glucose were compared in 10 recipients and 15 normal control subjects. There were no differences in fasting glucose levels or intravenous glucose disappearance rates. However, basal insulin levels and acute insulin responses to glucose were threefold greater in the recipients. It is not clear whether this consequence of hyperinsulinemia in the recipients is due to the abnormal circulatory drainage, the lack of autonomic input, or concurrent immunosuppressive drug therapy.

Long-term metabolic control in recipients of combined pancreas and kidney transplants

“…However, the study also shows that normoglycaemia does not necessarily indicate normalization of all parameters used to assess glucose homeostasis. A dissociation between normoglycaemia and other indicators used to characterize glucose metabolism has previously been demonstrated (Groth et al 1988;l.andgraf et al 1989;Robertson et al 1989;Nord6n et at. 1990).…”

“…The results from our study extend these observations showing that even in patients with abnormal HbA1 values, glucose disappearance curves and C-peptide responses still are normoglycaemic and without any need for exogenous insulin 5 years after transplantation. The inadequacy of a complete normalization of glucose metabolism seems to be similar whether the exocrine secretion of the pancreas is diverted to the intestine (Groth et al 1988) or to the bladder (Robertson et at. 1989;Nord6n et al 1990) or as in our study with occlusion of the ductal system with neoprene.…”

Transplante de pâncreas e ilhotas em portadores de diabetes melito

“…O controle glicêmico é semelhante em relação as duas técnicas de drenagem (16,17), visto que na drenagem portal o metabolismo lipoprotéico é melhor. Entretanto, a ocorrência de trombose é maior e o acesso para uma biópsia, em caso de necessidade, é mais dificultado (18).…”

Long-term follow-up of glycaemic control and parameters of lipid transport after pancreas transplantation

“…Successful pancreas transplantatiou is at present the only possibility to achieve long-term normoglycaemia and insulin-independence in patients with Type 1 (insulindependent) diabetes mellitus (Robertson et al 1989). However, the procedure is accompanied by peripheral hyperinsulinaemia because the pancreatic venous blood is drained into the systemic circulation rather than into the portal vein (Robertson et al 1989).…”

“…However, the procedure is accompanied by peripheral hyperinsulinaemia because the pancreatic venous blood is drained into the systemic circulation rather than into the portal vein (Robertson et al 1989).…”