Spain: Weight gain after pancreas transplantation (PT) is associated with a worse glycemic profile in patients with type 1 diabetes, a recent study has found. The study findings appear in the journal Diabetes Research and Clinical Practice.
Whole-organ pancreas and islet transplantations are performed in a highly selected group of patients with diabetes mellitus, primarily those with type 1 diabetes mellitus. Pancreas transplantation is most often performed simultaneous with a kidney transplant, but patients with particularly labile type 1 diabetes may be considered for a pancreas transplant alone. While highly successful at restoring insulin independence, pancreas transplants carry the significant risks of major surgery and immunosuppression.
Antonio J. Amor, Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain, and colleagues aimed to evaluate the weight trajectories after pancreas transplantation and their relationships with pancreas graft outcomes in type 1 diabetes (T1D) in a retrospective cohort study.
For this purpose, the researchers recruited type 1 diabetes who underwent pancreas transplantation. They were divided into three groups according to transplantation date: 1999-2004 (n=57), 2005-2009 (n=79), 2010-2015 (n=58). For weight comparisons, a random sample of T1D without renal impairment was also recruited during 2015 (n=61; T1D-control). The median follow-up for the T1D-PT group was 11.1 years.
Based on the study, the researchers found the following:
Despite significant weight loss at 6 months (65.7±12.4 vs. 64.1±11.4 Kg), a stepped increase was seen thereafter (60 months: 68.0±14.0 Kg).
Participants from the 2010-2015 period showed higher weight gain, outweighing that observed in the T1D-control (60 months: 4.69±8.49 vs. -0.97±4.59 Kg).
Weight gain between 6-36 months was directly associated with fasting glucose and HbA1c at 36 months, and with HbA1c at 60 months.
In Cox-regression models adjusted for age, sex, and several recipient and PT-related variables, the third tertile of weight gain between 6-36 months showed a non-significant increase in the graft failure/dysfunction (HR 2.33).
The researchers concluded that "weight gain post-PT was associated with glucose-related biochemical markers of graft dysfunction, which needs confirmation in further studies. However, this needs to be confirmed in further studies.
Reference:
The study titled, "Weight gain following pancreas transplantation in type 1 diabetes is associated with a worse glycemic profile: a retrospective cohort study," is published in the journal Diabetes Research and Clinical Practice.
DOI:https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(21)00385-5/fulltext