From the Division of Kidney and Pancreas Transplantation, Department of Surgery.
Asan Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Pancreas. 2021 Apr 1;50(4):587-594. doi: 10.1097/MPA.0000000000001800.
This study aimed to assess posttransplant changes in insulin sensitivity and β-cell function of pancreas transplant recipients according to the type of diabetes mellitus (DM) and the pretransplant insulin sensitivity measured by the Matsuda Index (MI).
We analyzed 60 patients who underwent pancreas transplantation and oral glucose tolerance test pretransplant and at 1 month posttransplant.
At 1 month posttransplant, insulin sensitivity did not show significant improvement; particularly, the MI was significantly lower after transplant in recipients with type 1 DM (T1DM) and those with pretransplant MI of 5 or greater. β-cell function was significantly improved after transplant in all recipients regardless of the type of DM and pretransplant MI values. Glucose control was significantly improved in recipients with T1DM and in all recipients regardless of the pretransplant MI values. Additional oral glucose tolerance test at 1 year posttransplant revealed that insulin sensitivity remained unimproved and β-cell function was higher compared with pretransplant. Glucose control had partially reverted to pretransplant levels in recipients with T1DM and those with pretransplant MI of 5 or greater.
Unlike β-cell function and glucose control, insulin sensitivity did not significantly improve until posttransplant 1 year after pancreas transplantation regardless of the type of DM or the degree of pretransplant insulin sensitivity.
本研究旨在评估根据糖尿病类型（DM）和移植前通过 Matsuda 指数（MI）测量的胰岛素敏感性，评估胰腺移植受者移植后胰岛素敏感性和胰岛β细胞功能的变化。
我们分析了 60 例接受胰腺移植并在移植前和移植后 1 个月进行口服葡萄糖耐量试验的患者。
移植后 1 个月，胰岛素敏感性无显著改善；特别是，1 型糖尿病（T1DM）受者和移植前 MI 值为 5 或更高的受者，移植后 MI 值显著降低。所有受者的胰岛β细胞功能在移植后均显著改善，而与 DM 类型和移植前 MI 值无关。T1DM 受者和所有受者的血糖控制均显著改善，而与移植前 MI 值无关。移植后 1 年再次进行口服葡萄糖耐量试验显示，胰岛素敏感性仍未改善，而β细胞功能较移植前更高。T1DM 受者和移植前 MI 值为 5 或更高的受者的血糖控制部分恢复至移植前水平。
与胰岛β细胞功能和血糖控制不同，胰岛素敏感性在胰腺移植后 1 年仍未显著改善，而与 DM 类型或移植前胰岛素敏感性程度无关。
