Hypoglycemic symptoms following pancreas transplantation

J. L. Larsen, R. J. Stratta, S. A. Miller, R. J. Taylor

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Vascularized pancreas transplantation (PTx) with non-portal venous drainage results in peripheral hyperinsulinemia which may predispose to hypoglycemia. The incidence and pattern of hypoglycemic symptoms following PTx was characterized in our patient population to determine if hypoglycemia could be a significant problem. A total of 54 PTx recipients (49 combined pancreas-kidney, 4 pancreas alone, and 1 pancreas after kidney) were surveyed 2 to 33 months post-transplant. Twenty-nine of 54 PTx recipients (54%) reported symptoms of hypoglycemia at any time following their transplant operation. Of those reporting hypoglycemic symptoms, most had very few episodes (26/29 had ≤ 1-3/month). The symptoms were reported as occurring before meals or at night in 10 (34.5%), post-prandial in 10 (34.5%), both pre- and postprandial in 1 (3.5%), and or with no specific pattern in 8 (27.5%). Only 12 of 29 tried to document blood glucose during any episode. Of those 12, only 5 documented a blood glucose during the episode of less than 60 mg/dl although another 5 documented a blood glucose from 60-70 mg/dl. The PTx recipients with hypoglycemic symptom episodes had a lower body mass index (BMI), a longer post-PTx time interval, a lower prednisone dose (all p<0.01), a lower glycohemoglobin (p=0.0196) and a higher fasting glucagon (p=0.035) compared to recipients without symptoms. In summary, symptoms of hypoglycemia were reported by 54% of PTx recipients, but the symptoms, when present, were infrequent. The recipients reporting symptoms were less likely to be insulin-resistant (longer post-PTχ, lower BMI, and on lower doses of prednisone). Although hypoglycemia was documented during some episodes, no glucose concentration was available for most episodes of hypoglycemic symptoms so the incidence of actual hypoglycemia among PTx recipients is still unknown.

Original languageEnglish (US)
Pages (from-to)520-524
Number of pages5
JournalClinical Transplantation
Volume7
Issue number6
StatePublished - 1993

Keywords

  • Diabetes mellitus
  • Hypoglycemia
  • Kidney transplantation
  • Pancreas transplantation

ASJC Scopus subject areas

  • Transplantation

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  • Cite this

    Larsen, J. L., Stratta, R. J., Miller, S. A., & Taylor, R. J. (1993). Hypoglycemic symptoms following pancreas transplantation. Clinical Transplantation, 7(6), 520-524.