Glucose metabolism after pancreas transplantation

After pancreas transplantation in type-I diabetics the dependency on exogenous insulin usually vanishes rapidly. In about 50% of patients fasting and postprandial blood glucose concentrations are normal but by oral glucose tolerance tests the glucose metabolism is classified as normal in a minority. Some of the reasons for failure in obtaining good metabolic control are discussed. Attention is focused on the inevitable peripheral hyperinsulinemia and concomitant portal hypoinsulinemia related to the extra-portal administration of insulin.