PREVALENCE OF LOW BLOOD-GLUCOSE SYMPTOMS AND QUALITY-OF-LIFE IN PANCREAS TRANSPLANT RECIPIENTS

One hundred and twenty-nine Type I diabetic pancreas transplant recipi ents who were at least 1 year post-transplant (n = 62 functioning graf t, n = 67 non-functioning graft) completed a quality of life questionn aire that included self-report ratings of symptoms. Reports of frequen t low blood glucose symptoms, distress due to low blood glucose sympto ms, and subjective ratings of poorer blood glucose control were signif icantly and highly correlated with dissatisfaction ratings on diabetes -specific measures of satisfaction with lifestyle, health and treatmen t (r = 0.43 to 0.67, p < 0.01). Overall life satisfaction and physical functioning were also significantly correlated with these symptom per ceptions (r = 0.23 to 0.43, p < 0.01). Symptoms had a significant impa ct on quality of life measures even after adjustement for the effects of pancreas graft status and other case-mix factors. The prevalence of reported low blood glucose symptoms in the previous month was about o ne-third for patients with a functioning pancreas graft (n = 19) compa red to almost all patients in the non-functioning group (31% vs. 97%, p < 0.0001). A limitation of this study is the absence of documented b lood glucose values to correlate with symptom perceptions. Perceived l ow blood glucose symptoms could be inaccurate, particularly for very m ild symptoms, and correlation with actual blood glucose may be very lo w. The symptomatic patients with functioning grafts generally reported a few mild symptoms per month, and this study was not able to demonst rate that symptomatic patients with functioning grafts have reduced qu ality of life. Thus, while the prevalence of transient self-reported s ymptoms of hypoglycemia in successful pancreas transplant recipients i s 31% in this series, the severity of their symptoms is insufficient t o impact quality of life measures.