Hypoglycemia after pancreas transplantation

Area of Science:

• Endocrinology
• Transplantation Immunology
• Metabolic Disorders

Background:

• Hypoglycemia is a serious complication of diabetes therapy.
• Pancreas transplantation is considered for improving quality of life in diabetic patients.
• Some pancreas transplant recipients report symptoms of mild hypoglycemia.

Purpose of the Study:

• To investigate glucose and hormone levels in pancreas transplant recipients with and without hypoglycemia symptoms.
• To compare these levels with healthy control subjects.

Main Methods:

• Studied glucose and hormone levels in three groups: symptomatic pancreas transplant recipients (n=10), asymptomatic recipients (n=9), and healthy controls (n=8).
• Measurements were taken after a mixed meal and during a 24-hour modified fast.
• All transplant recipients were insulin-independent and on immunosuppressive therapy.

Main Results:

• No significant differences in fasting glucose, insulin, C-peptide, or glucagon between symptomatic and asymptomatic transplant groups.
• During a 24-hour fast, glucose levels were lower in the symptomatic group (71+/-2 mg/dl) compared to the asymptomatic group (81+/-2 mg/dl).
• Five symptomatic recipients reported hypoglycemia during the study; four experienced transient drops in glucose, with symptoms resolving spontaneously. One recipient had insulin antibodies.

Conclusions:

• Some pancreas transplant recipients experience transient symptomatic postprandial hypoglycemia.
• Fasting hypoglycemia was not evident, except possibly in one case with insulin antibodies.
• Postprandial hypoglycemia appears to be a minor clinical issue in pancreas transplant recipients.