Hypoglycemic symptoms following pancreas transplantation

Jennifer Lynn Larsen, R. J. Stratta, S. A. Miller, R. J. Taylor

Research output: Contribution to journalArticle

16 Citations (Scopus)

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 - Jan 1 1993

Fingerprint

Pancreas Transplantation
Hypoglycemia
Hypoglycemic Agents
Blood Glucose
Pancreas
Prednisone
Meals
Body Mass Index
Transplants
Kidney
Incidence
Hyperinsulinism
Glucagon
Drainage
Fasting
Insulin
Glucose
Population

Keywords

  • Diabetes mellitus
  • Hypoglycemia
  • Kidney transplantation
  • Pancreas transplantation

ASJC Scopus subject areas

  • Transplantation

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.

Hypoglycemic symptoms following pancreas transplantation. / Larsen, Jennifer Lynn; Stratta, R. J.; Miller, S. A.; Taylor, R. J.

In: Clinical Transplantation, Vol. 7, No. 6, 01.01.1993, p. 520-524.

Research output: Contribution to journalArticle

Larsen, JL, Stratta, RJ, Miller, SA & Taylor, RJ 1993, 'Hypoglycemic symptoms following pancreas transplantation', Clinical Transplantation, vol. 7, no. 6, pp. 520-524.
Larsen JL, Stratta RJ, Miller SA, Taylor RJ. Hypoglycemic symptoms following pancreas transplantation. Clinical Transplantation. 1993 Jan 1;7(6):520-524.
Larsen, Jennifer Lynn ; Stratta, R. J. ; Miller, S. A. ; Taylor, R. J. / Hypoglycemic symptoms following pancreas transplantation. In: Clinical Transplantation. 1993 ; Vol. 7, No. 6. pp. 520-524.
@article{ac1838a13ea14881b9d84af54b0a6451,
title = "Hypoglycemic symptoms following pancreas transplantation",
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.",
keywords = "Diabetes mellitus, Hypoglycemia, Kidney transplantation, Pancreas transplantation",
author = "Larsen, {Jennifer Lynn} and Stratta, {R. J.} and Miller, {S. A.} and Taylor, {R. J.}",
year = "1993",
month = "1",
day = "1",
language = "English (US)",
volume = "7",
pages = "520--524",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Hypoglycemic symptoms following pancreas transplantation

AU - Larsen, Jennifer Lynn

AU - Stratta, R. J.

AU - Miller, S. A.

AU - Taylor, R. J.

PY - 1993/1/1

Y1 - 1993/1/1

N2 - 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.

AB - 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.

KW - Diabetes mellitus

KW - Hypoglycemia

KW - Kidney transplantation

KW - Pancreas transplantation

UR - http://www.scopus.com/inward/record.url?scp=0027445139&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027445139&partnerID=8YFLogxK

M3 - Article

VL - 7

SP - 520

EP - 524

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 6

ER -