Földes K, Piros L, Toronyi E, Wagner L, Chmel R, Török Sz, Nagy K, Ghimessy A, Brinzanek D, Pőcze B, Langer R M, Gerő L
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
Transplant Proc. 2013;45(10):3698-702. doi: 10.1016/j.transproceed.2013.10.006.
End-stage renal failure, a frequent complication of type 1 diabetes mellitus, requires renal replacement therapy. Our team examined the laboratory parameters of carbohydrate metabolism in 18 patients with type 1 diabetes at 10 to 89 months after simultaneous pancreas-kidney transplantation. We compared these results with those of 17 patients with type 1 diabetes who had formerly received kidney-alone transplantations, and were undergoing insulin treatment, as well as with those of 16 metabolically healthy controls. The hemoglobin A1c (HbA1c) and blood glucose levels of the pancreas-kidney transplant recipients were within the normal ranges, not differing significantly from those of the healthy controls. In contrast, the HbA1c and glucose levels were significantly elevated among kidney transplanted diabetic subjects. However, fasting and 2-hour insulin levels of pancreas-kidney transplant patients were significantly higher than those of the controls, indicating insulin resistance. According to these results, the insulin secretion by the pancreas graft sufficiently compensated for insulin resistance. Thus 10 to 89 months after successful pancreas-kidney transplantation, carbohydrate metabolism by type 1 diabetic patients was well controlled without antidiabetic therapy.
终末期肾衰竭是1型糖尿病的常见并发症，需要进行肾脏替代治疗。我们的团队检测了18例1型糖尿病患者在同期胰腺-肾脏移植术后10至89个月时的碳水化合物代谢实验室参数。我们将这些结果与17例曾接受单纯肾脏移植且正在接受胰岛素治疗的1型糖尿病患者的结果进行了比较，同时也与16例代谢健康的对照组进行了比较。胰腺-肾脏移植受者的糖化血红蛋白（HbA1c）和血糖水平在正常范围内，与健康对照组相比无显著差异。相比之下，接受肾脏移植的糖尿病患者的HbA1c和血糖水平显著升高。然而，胰腺-肾脏移植患者的空腹和2小时胰岛素水平显著高于对照组，表明存在胰岛素抵抗。根据这些结果，移植胰腺分泌的胰岛素充分补偿了胰岛素抵抗。因此，在成功进行胰腺-肾脏移植术后10至89个月，1型糖尿病患者的碳水化合物代谢在未进行抗糖尿病治疗的情况下得到了良好控制。
