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  • 1
    ISSN: 1432-0428
    Keywords: Pancreas transplantation ; Insulin resistance ; Insulin action ; Insulin binding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin action and insulin specific binding to erythrocytes were examined in ten recipients of a pancreatic segment and renal graft (Group 1), in nine non-diabetic kidney recipients (Group 2) and in ten age- and weight-matched healthy control subjects (Group 3). All transplant recipients were normoglycaemic without need of insulin, received the same immunosuppression and had good renal graft function at 11–18 months post-transplantation, when the investigation was performed. Using the insulin clamp technique, insulin action was expressed as the metabolic clearance rate of glucose at insulin infusion rates of 1.0 (MCRsubmax) and 10.0 (MCRmax) mU·kg−1·min−1. In comparison with the healthy control subjects, fasting free insulin and C-peptide levels were significantly higher in Groups 1 and 2, but no differences between Groups 1 and 2 were found (p〉0.05). Mean values±SEM of MCRsubmax in Groups 1, 2 and 3 were 6.30±0.55, 6.09 ±0.69 and 10.52±1.10 ml·kg−1·min−1 respectively, and of MCRmax 12.65±0.78, 13.14±0.92 and 19.28±1.42 ml·kg−1·min−1 respectively. Insulin action was significantly decreased in Groups 1 and 2 at the low as well as the high insulin infusion rates but there was no difference between the two groups of recipients (p〉0.05). No differences in binding data (specific binding, number of binding sites per cell) were found. It is concluded that insulin resistance is common to all immunosuppressed organ recipients and is not related to the pancreas graft. The decreased maximal response to insulin and normal insulin binding to erythrocytes tend to suggest a post-receptor defect in insulin action.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Pancreatic transplantation ; Autonomic neuropathy ; Cardiovascular function tests
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have evaluated the effect of successful pancreatic and kidney transplantation on autonomic neuropathy in nine Type 1 (insulin-dependent) diabetic subjects. Cardiovascular reflex tests were performed before and at 6–24 months after transplantation. A control group of ten Type 1 diabetic patients after kidney grafting only was examined at the same time periods. For base-line comparisons results of the tests in ten healthy subjects were used. Advanced autonomic neuropathy was present in both groups of transplant recipients and no significant changes in test results could be found at post-transplant evaluation. Lack of autonomic nerve function improvement was confirmed in seven patients of the pancreatic and kidney transplantation group who were examined again after 2–4 years. Irreversible structural autonomic nerve damage is probably present in uraemic pancreatic transplantation candidates.
    Type of Medium: Electronic Resource
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