ECE2015 Eposter Presentations Diabetes (complications & therapy) (143 abstracts)
Simultaneous pancreas–kidney transplantation effect on stabilisation/progression of diabetic complications in patients with type 1 diabetes
Alexandra Glazunova 1 , Margarita Arutyunova 1 , Gulia Musaeva 5 , Minara Shamkhalova 1 , Marina Shestakova 1, , Yan Moysyuk 2 , Alexey Pinchuk 3 , Ilya Dmitriev 3 & Sergey Arzumanov 4
1Research Centre of Endocrinology, Moscow, Russia; 2Academician V.I. Shumakov Federal Research Centre of Transplantology and Artificial organs, Moscow, Russia; 3N.V. Sklifosofskiy Moscow Health Department, Research Institute of Emergency Care, Moscow, Russia; 4Federal Research Centre of Urology, Moscow, Russia; 5I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Objective: To evaluate the simultaneous pancreas–kidney transplantation (SPK) effect on stabilisation/progression of complications in patients with T1DM.
Materials and methods: The study included 16 patients after SPK. Eleven peoples received standard triple immunosuppressive therapy during the study period, five patients canceled steroid therapy after 6 months. The average age was 34 years old (31; 40), duration of T1DM 22 years (20.5; 28), the duration of diabetic nephropathy10 years (8; 14.5). The duration of dialysis therapy was 2 years (0.9; 2.5). All patients remained in the study for at least months 21 (10; 36) after the transplantation. Pancreas transplant chronic rejection with normal kidney transplant function was observed in one patient in 1 year after the operation.
Results: The mean level of HbA1c before the study was 8.65% (8.4; 9.1), then decreased to 5.6% (5.5; 5.8) after SPK. According to a continuous glucose monitoring system using «iPRO2» euglycaemia (glycaemia (mmol/l) 3.9–8.9–89%, lower than 3.9–11%, and higher than 8.9–0%) was marked during the day. The level of C-peptide was 2.02 ng/ml (1.07; 2.77), of insulin 12.5 mkE/ml (11.4; 15.3), and GFR 76 ml/min per 1.73 m2 (68; 90). All patients had normoalbuminuria, normal levels of hemoglobin 120 g/l (112; 130), parathormone 77.3 pg/ml (60.4; 92.5), phosphorus 1.2 mmol/l (1.05; 1.4), and blood pressure 110 mmHg (100.0; 120). The proliferative diabetic retinopathy progression which required vitrectomy and additional laser panretinal photocoagulation sessions was observed in 18.75% of patients. Nonstenotic atherosclerosis of the lower extremities was detected in 13 peoples, ulcerative defects in the lower limbs in five patients and chronic osteoarthropathy progression in four cases.
Conclusions: Despite the euglycaemia and renal function normalisation after SPK the progression of diabetic complications was observed. This fact indicates the need of further monitoring and treatment in this category of patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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