Background. Current insulin therapies for control of glucose metabolis
m in patients with type I diabetes mellitus prevent major metabolic co
nsequences of insulin deficiency, but none prevents or arrests longter
m complications, In experimental models of canine diabetes, retinopath
y, neuropathy, and nephropathy have been shown to develop within 5 yea
rs, The aim of this study was to determine in a canine model whether g
lucose control provided by segmental duct-occluded pancreas autografts
could prevent the long-term complications of diabetes. Methods, Thirt
y-five outbred mongrel dogs underwent segmental pancreas autotransplan
tation with residual pancreatectomy, Follow-up over 5 years included e
ndocrine, retinal fundus photography, fluorescein angiography, and ner
ve conduction studies, At endpoint, analysis of organ specific changes
was undertaken, Results, Long-term survival was achieved in 14 dogs f
or 4 to 5 years and in 3 dogs for 3 to 5 years, Glycosylated hemoglobi
n levels remained within normal limits, although response to glucose c
hallenge was suboptimal, Fundus photography and fluorescein angiograph
y demonstrated the absence of retinal vascular aneurisms, capillary le
akage, and obliteration, Retinal digest showed no vascular changes and
normal endothelial/pericyte ratios. Nerve conduction was normal, and
histology of nerves revealed normal density of myelinated fibers and a
bsence of intrafascicular vessels and glycogen deposits, with no chang
e in spectrum of fiber diameters and ovoids, Renal histology revealed
no evidence of nephropathy with normal glomerular basement membranes,
Conclusions, We have demonstrated that duct-occluded segmental pancrea
tic autografts are capable of providing satisfactory metabolic control
for up to 5 years, thereby preventing development of the longterm mic
rovascular complications of diabetes.