Quality of life in Japanese patients with type 1 diabetes and end-stage renal disease undergoing simultaneous pancreas and kidney transplantation

Abstract

We conducted this cross-sectional study to assess quality of life (QOL) in Japanese patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease (ESRD) undergoing simultaneous pancreas and kidney transplantation (SPK). Japanese patients with T1DM without diabetic nephropathy (N = 10), and those undergoing chronic dialysis (N = 52), kidney transplantation alone (KTA, N = 25), and SPK (N = 16) were studied. Comprehensive health-related QOL was assessed using the Short Form 36 version 2 (SF-36v2). Emotional functioning in diabetes was measured by the Problem Area In Diabetes (PAID) scale. Severity of impaired hypoglycemic awareness was assessed using the Clarke hypoglycemic score. SPK patients had significantly higher (or tended to have higher) subscale and summary SF-36 scores than dialysis patients and KTA patients. PAID scores were significantly lower in SPK patients than in dialysis patients and KTA patients. Clarke hypoglycemic scores were also significantly lower in SPK patients than dialysis patients. In KTA and dialysis patients, there were no significant differences in the SF-36 subscale/summary scores, PAID scores, or Clarke hypoglycemic scores. In conclusion, QOL for Japanese patients receiving SPK may be superior to that of dialysis patients and KTA patients. Whether SPK actually improves QOL needs to be clarified in longitudinal studies.

The quality of life in type I diabetic patients with end‐stage kidney disease before and after simultaneous pancreas‐kidney transplantation: a single‐center prospective study

“…This outcome may be the result of the stabilization of the levels of glycated hemoglobin provided by pancreas transplantation. It is also due to the symbiosis between the two transplanted organs, with the grafts providing mutual protection for each other .…”

Psychological care of patients during the pancreas transplantation process: issues and prospects

“…The integration of psychotherapeutic sessions into medical follow-ups after transplantation is also recommended, as this transitional period may be characterized by an increased prevalence of psychological symptoms that affect patients’ quality of life ( 43 , 44 ). Gibbons et al.…”

Impact of Pancreas Transplantation on the Patient Survival—An Analysis of the Japanese Pancreas Transplants Registry

“…Pancreatic transplantation should be considered as complementary medicine for patients with impaired insulin secretion and poor blood glucose control. With pancreatic transplantation, patients can expect not only an improvement in their quality of life [3][4][5][6], resulting from the stabilization of blood glucose, but also an improvement in their life prognosis as the result of controlling diabetic nephropathy [7], the cardiac function [8], microangiopathy [9], neuropathy [10,11] and hyperlipidemia [12]. Gruessner et al [13] reported that the four-year patient survival rates of pancreas transplant recipients were significantly improved in comparison to patients on the waiting lists for the simultaneous pancreas and kidney transplantation (SPK; 90.3% vs. 58.7%); for pancreas transplantation after kidney transplantation (PAK; 88.3% vs. 81.7%); and for pancreas transplantation alone (PTA; 90.5% vs. 87.3%).…”