Pancreas transplantation improves vascular disease in patients with type 1 diabetes

Jennifer Lynn Larsen, Christopher W. Colling, Tanaporn Ratanasuwan, Tab W. Burkman, Thomas G. Lynch, Judi M. Erickson, Elizabeth R. Lyden, James T. Lane, Lynn R Mack

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

OBJECTIVE - Pancreas transplantation (PTX) normalizes glucose and improves microvascular complications, but its impact on macrovascular disease is still debated. RESEARCH DESIGN AND METHODS - Carotid intima-media thickness (1MT), shown to correlate with cardiovascular disease (CVD) risk and events, was determined prospectively by ultrasonography in successful pancreas transplant recipients to evaluate the effect of PTX on CVD risk. Carotid 1MT and CVD risk factors of pancreas transplant recipients (n = 25) were compared with three groups: individuals with type 1 diabetes without significant nephropathy (n = 20), nondiabetic kidney transplant recipients (n = 16), and normal control subjects (n = 32). Mean age of pancreas transplant recipients at the time of transplantation was 42.4 ± 1.2 years (mean ± SE) and duration of diabetes was 25.9 ± 1.4 years. RESULTS - After PTX, HbA1c level (P < 0.0001) decreased to normal and, whereas creatinine level (P = 0.0002) decreased, it remained elevated compared with normal control subjects (P < 0.05). Blood pressure, BMI, fasting lipid levels, smoking frequency, and use of hypolipidemic agents were unchanged. Mean carotid 1MT was increased in pancreas transplant candidates but decreased by 1.8 ± 0.1 year after PTX (P = 0.0068), no longer different from that in normal control subjects or patients with type 1 diabetes. CONCLUSIONS - Carotid 1MT improves after successful PTX within 2 years of the procedure, with normalization of HbA 1c and improved renal function, independent of changes in lipid levels, BM1, blood pressure, smoking, or use of hypolipidemic agents. This study suggests that CVD risk, future events, and mortality should improve after PTX in the absence of other significant, untreated CVD risk factors.

Original languageEnglish (US)
Pages (from-to)1706-1711
Number of pages6
JournalDiabetes Care
Volume27
Issue number7
DOIs
StatePublished - Jul 1 2004

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Pancreas Transplantation
Type 1 Diabetes Mellitus
Vascular Diseases
Cardiovascular Diseases
Pancreas
Hypolipidemic Agents
Smoking
Blood Pressure
Kidney
Lipids
Carotid Intima-Media Thickness
Fasting
Ultrasonography
Creatinine
Research Design
Transplantation
Transplants
Glucose
Mortality
Transplant Recipients

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Pancreas transplantation improves vascular disease in patients with type 1 diabetes. / Larsen, Jennifer Lynn; Colling, Christopher W.; Ratanasuwan, Tanaporn; Burkman, Tab W.; Lynch, Thomas G.; Erickson, Judi M.; Lyden, Elizabeth R.; Lane, James T.; Mack, Lynn R.

In: Diabetes Care, Vol. 27, No. 7, 01.07.2004, p. 1706-1711.

Research output: Contribution to journalArticle

Larsen, JL, Colling, CW, Ratanasuwan, T, Burkman, TW, Lynch, TG, Erickson, JM, Lyden, ER, Lane, JT & Mack, LR 2004, 'Pancreas transplantation improves vascular disease in patients with type 1 diabetes', Diabetes Care, vol. 27, no. 7, pp. 1706-1711. https://doi.org/10.2337/diacare.27.7.1706
Larsen JL, Colling CW, Ratanasuwan T, Burkman TW, Lynch TG, Erickson JM et al. Pancreas transplantation improves vascular disease in patients with type 1 diabetes. Diabetes Care. 2004 Jul 1;27(7):1706-1711. https://doi.org/10.2337/diacare.27.7.1706
Larsen, Jennifer Lynn ; Colling, Christopher W. ; Ratanasuwan, Tanaporn ; Burkman, Tab W. ; Lynch, Thomas G. ; Erickson, Judi M. ; Lyden, Elizabeth R. ; Lane, James T. ; Mack, Lynn R. / Pancreas transplantation improves vascular disease in patients with type 1 diabetes. In: Diabetes Care. 2004 ; Vol. 27, No. 7. pp. 1706-1711.
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abstract = "OBJECTIVE - Pancreas transplantation (PTX) normalizes glucose and improves microvascular complications, but its impact on macrovascular disease is still debated. RESEARCH DESIGN AND METHODS - Carotid intima-media thickness (1MT), shown to correlate with cardiovascular disease (CVD) risk and events, was determined prospectively by ultrasonography in successful pancreas transplant recipients to evaluate the effect of PTX on CVD risk. Carotid 1MT and CVD risk factors of pancreas transplant recipients (n = 25) were compared with three groups: individuals with type 1 diabetes without significant nephropathy (n = 20), nondiabetic kidney transplant recipients (n = 16), and normal control subjects (n = 32). Mean age of pancreas transplant recipients at the time of transplantation was 42.4 ± 1.2 years (mean ± SE) and duration of diabetes was 25.9 ± 1.4 years. RESULTS - After PTX, HbA1c level (P < 0.0001) decreased to normal and, whereas creatinine level (P = 0.0002) decreased, it remained elevated compared with normal control subjects (P < 0.05). Blood pressure, BMI, fasting lipid levels, smoking frequency, and use of hypolipidemic agents were unchanged. Mean carotid 1MT was increased in pancreas transplant candidates but decreased by 1.8 ± 0.1 year after PTX (P = 0.0068), no longer different from that in normal control subjects or patients with type 1 diabetes. CONCLUSIONS - Carotid 1MT improves after successful PTX within 2 years of the procedure, with normalization of HbA 1c and improved renal function, independent of changes in lipid levels, BM1, blood pressure, smoking, or use of hypolipidemic agents. This study suggests that CVD risk, future events, and mortality should improve after PTX in the absence of other significant, untreated CVD risk factors.",
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