Late Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation

Aim. The aim of this study was to investigate late diabetic complications in patients with Type 1 diabetes mellitus (T1DM) who received simultaneous pancreas-kidney transplantation (SPK). Materials and Methods. The study included 16 patients with T1DM who received SPK. All patients underwent clini...

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Autores principales:	Alexandra Michailovna Glazunova, Margarita Stanislavovna Arutyunova, Evgeny Vladimirovich Tarasov, Minara Shamkhalovna Shamhalova, Marina Vladimirovna Shestakova, Yan Gennad'evich Moysyuk, Aleksey Valer'evich Pinchuk, Ilya Viktorovich Dmitriev, Sergei Viktorovich Arzumanov
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2015
Materias:	diabetes mellitus type 1 diabetic nephropathy simultaneous pancreas-kidney transplantation complications of diabetes Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/2621a323d55148359f830f39fbdb73b7
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spelling	oai:doaj.org-article:2621a323d55148359f830f39fbdb73b72021-11-14T09:00:19ZLate Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation2072-03512072-037810.14341/DM2015269-78https://doaj.org/article/2621a323d55148359f830f39fbdb73b72015-06-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/6990https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Aim. The aim of this study was to investigate late diabetic complications in patients with Type 1 diabetes mellitus (T1DM) who received simultaneous pancreas-kidney transplantation (SPK). Materials and Methods. The study included 16 patients with T1DM who received SPK. All patients underwent clinical examination and diagnostic investigation. Results. After SPK, 93.75% of the patients had a functioning pancreas transplant, and 100% had a functioning kidney transplant within 4?48 months [mean 21 months (10 is revealed; 36)). All patients had euglycaemia according to daily monitoring. The mean level of glycated haemoglobin (HbA1c) before surgery was 9.1% (range 8.7%?11%) and was 5.7% after surgery (5.55%?5.9%; p < 0.0001). The baseline level of insulin was 12.5 ?IU/ml (11.4?15.3 ?IU/ml) and the baseline level of C-peptide was 2.02 ng/ml (1.07?2.77 ng/ml). Normal renal function was observed (glomerular filtration rate 76 ml/min/1.73 m2 (68?90 ml/min/1.73 m2). Other laboratory findings included haemoglobin 127 g/l (120?130 g/l), serum parathyroid hormone 77.5 pg/ml (61?85 pg/ml), serum phosphate 1.2 mmol/l (1.07?1.3 mmol/l) and blood pressure 110(100?120)/70(64?80) mmHg. In 37.5% of the patients, vitrectomy and additional laser panretinal photocoagulation were performed for proliferative diabetic retinopathy. Other ophthalmological disorders included newly diagnosed cataract (81.25%), secondary cataract (25%) that required YAG discission in three patients, glaucoma (25%) and macular oedema (12.5%). Ulcers of the lower extremities were observed in 31.25% of the patients, and chronic osteoarthropathy was observed in four. One patient underwent amputation of index and ring fingers and resection of the first and third metatarsal heads to treat osteomyelitis. One patient underwent balloon angioplasty and stenting for advanced atherosclerotic stenosis of blood vessels of the lower extremities. Conclusions. Euglycaemia and recovery of renal function 6?48 months after SPK resulted in a significant decrease in diabetic complications without clinical signs of regression in some patients. However, some patients suffered progression of complications, reflecting their multifactorial causes. These findings highlight the need for timely diagnosis, treatment and long-term follow up to improve the quality of life and prognosis in patients with T1DM receiving SPK.Alexandra Michailovna GlazunovaMargarita Stanislavovna ArutyunovaEvgeny Vladimirovich TarasovMinara Shamkhalovna ShamhalovaMarina Vladimirovna ShestakovaYan Gennad'evich MoysyukAleksey Valer'evich PinchukIlya Viktorovich DmitrievSergei Viktorovich ArzumanovEndocrinology Research Centrearticlediabetes mellitus type 1diabetic nephropathysimultaneous pancreas-kidney transplantationcomplications of diabetesNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 18, Iss 2, Pp 69-78 (2015)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	diabetes mellitus type 1 diabetic nephropathy simultaneous pancreas-kidney transplantation complications of diabetes Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	diabetes mellitus type 1 diabetic nephropathy simultaneous pancreas-kidney transplantation complications of diabetes Nutritional diseases. Deficiency diseases RC620-627 Alexandra Michailovna Glazunova Margarita Stanislavovna Arutyunova Evgeny Vladimirovich Tarasov Minara Shamkhalovna Shamhalova Marina Vladimirovna Shestakova Yan Gennad'evich Moysyuk Aleksey Valer'evich Pinchuk Ilya Viktorovich Dmitriev Sergei Viktorovich Arzumanov Late Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation
description	Aim. The aim of this study was to investigate late diabetic complications in patients with Type 1 diabetes mellitus (T1DM) who received simultaneous pancreas-kidney transplantation (SPK). Materials and Methods. The study included 16 patients with T1DM who received SPK. All patients underwent clinical examination and diagnostic investigation. Results. After SPK, 93.75% of the patients had a functioning pancreas transplant, and 100% had a functioning kidney transplant within 4?48 months [mean 21 months (10 is revealed; 36)). All patients had euglycaemia according to daily monitoring. The mean level of glycated haemoglobin (HbA1c) before surgery was 9.1% (range 8.7%?11%) and was 5.7% after surgery (5.55%?5.9%; p < 0.0001). The baseline level of insulin was 12.5 ?IU/ml (11.4?15.3 ?IU/ml) and the baseline level of C-peptide was 2.02 ng/ml (1.07?2.77 ng/ml). Normal renal function was observed (glomerular filtration rate 76 ml/min/1.73 m2 (68?90 ml/min/1.73 m2). Other laboratory findings included haemoglobin 127 g/l (120?130 g/l), serum parathyroid hormone 77.5 pg/ml (61?85 pg/ml), serum phosphate 1.2 mmol/l (1.07?1.3 mmol/l) and blood pressure 110(100?120)/70(64?80) mmHg. In 37.5% of the patients, vitrectomy and additional laser panretinal photocoagulation were performed for proliferative diabetic retinopathy. Other ophthalmological disorders included newly diagnosed cataract (81.25%), secondary cataract (25%) that required YAG discission in three patients, glaucoma (25%) and macular oedema (12.5%). Ulcers of the lower extremities were observed in 31.25% of the patients, and chronic osteoarthropathy was observed in four. One patient underwent amputation of index and ring fingers and resection of the first and third metatarsal heads to treat osteomyelitis. One patient underwent balloon angioplasty and stenting for advanced atherosclerotic stenosis of blood vessels of the lower extremities. Conclusions. Euglycaemia and recovery of renal function 6?48 months after SPK resulted in a significant decrease in diabetic complications without clinical signs of regression in some patients. However, some patients suffered progression of complications, reflecting their multifactorial causes. These findings highlight the need for timely diagnosis, treatment and long-term follow up to improve the quality of life and prognosis in patients with T1DM receiving SPK.
format	article
author	Alexandra Michailovna Glazunova Margarita Stanislavovna Arutyunova Evgeny Vladimirovich Tarasov Minara Shamkhalovna Shamhalova Marina Vladimirovna Shestakova Yan Gennad'evich Moysyuk Aleksey Valer'evich Pinchuk Ilya Viktorovich Dmitriev Sergei Viktorovich Arzumanov
author_facet	Alexandra Michailovna Glazunova Margarita Stanislavovna Arutyunova Evgeny Vladimirovich Tarasov Minara Shamkhalovna Shamhalova Marina Vladimirovna Shestakova Yan Gennad'evich Moysyuk Aleksey Valer'evich Pinchuk Ilya Viktorovich Dmitriev Sergei Viktorovich Arzumanov
author_sort	Alexandra Michailovna Glazunova
title	Late Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation
title_short	Late Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation
title_full	Late Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation
title_fullStr	Late Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation
title_full_unstemmed	Late Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation
title_sort	late diabetic complications in patients with type 1 diabetes who received simultaneous pancreas-kidney transplantation
publisher	Endocrinology Research Centre
publishDate	2015
url	https://doaj.org/article/2621a323d55148359f830f39fbdb73b7
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Late Diabetic Complications in Patients with Type 1 Diabetes who Received Simultaneous Pancreas-Kidney Transplantation

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