METABOLIC CHARACTERIZATION OF LONG-TERM SUCCESSFUL PANCREAS TRANSPLANTS IN TYPE-I DIABETES

Background: The encouraging results of the Diabetes Control and Compli cations Trial emphasize the need for improved methods of glycemic cont rol to prevent the potentially devastating complications of Type I dia betes mellitus, However, current conventional approaches have failed t o consistently achieve normal HbAlc levels and increase the risk of hy poglycemia. Pancreas transplantation is a consistently reliable method of achieving postoperative normal glucose levels, but no extensive as sessment has been made of the long-term stability of its metabolic ben efits. Methods: To ascertain long-term stability of metabolic function of pancreas transplants in Type I diabetic patients, we studied fasti ng glucose levels, glucose disposal after intravenous glucose challeng e, HbAlc levels, and pancreatic islet beta and alpha cell responsivene ss in a series of 96 successfully transplanted recipients, Patients we re studied cross-sectionally and, when possible, longitudinally for up to five years post-transplantation. Special emphasis was given to the longitudinal analysis to determine whether initial metabolic benefits maintain stability or undergo deterioration during the first five pos toperative years.