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  • Diabetes (pancreatic transplant)

    Diabetes is a disease that effects more than 8% of the US population, including children, adolescents, adults, and seniors, and is the result of high glucose levels in the blood. Located under the stomach, the pancreas is the organ responsible for producing the hormone insulin and digestive juices. Insulin allows the body to open its cells to receive a simple sugar called glucose and utilize it to create energy.

    Type 1 diabetics are unable to produce the insulin needed to make that important conversion and must take daily insulin injections to process the glucose in their body.

    Type 2 diabetics may have one of two problems; insulin production may be insufficient, or patients may develop a resistance to it at the cellular level.

    Gestational diabetes usually begins around 24 weeks gestation. It occurs in approximately 18% of pregnancies, and is triggered by shifting maternal hormones.

    Without insulin, the body’s cells cannot receive glucose and sugar remains in the blood stream. If the individual’s blood sugar count remains high, it can cause significant damage to the eyes, kidneys, nerves and heart.

    Causes

    The underlying cause of diabetes is a lack of insulin production altogether, as in type 1 diabetes, an insufficient insulin production, as in type 2 diabetes, or an inability to use insulin, also characteristic of type 2 diabetes. All of these insulin-related deficiencies lead to a build of excess glucose in the blood, which is diagnosed as diabetes. Being overweight, living a sedentary lifestyle and having a family history of diabetes are considered risk factors for developing diabetes. Diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders, as well as the aging population.

    Symptoms

    Type 1 diabetes symptoms include:
    • Urinating large amounts of dilute, clear urine
    • Excessive thirst
    • Excessive hunger
    • Weight loss
    • Fatigue
    • Irritability

    In addition to these symptoms, patients with both type 1 and type 2 diabetes may also experience blurry vision, slow-healing cuts, bruises, numbness and/or tingling in the extremities, and reoccurring infections.

    Testing and diagnosis

    A urinalysis is often a first line test used to detect ketones or glucose in the urine and may guide providers in additional screenings.

    Diabetes can be diagnosed by measuring the amount of excess glucose present in the blood. Three different tests can be used to quantify the blood glucose level. The three tests are called A1C, FPG (fasting plasma glucose), and OGTT (oral glucose tolerance). The A1C test involves monitoring your blood glucose for two to three months.

    Treatment

    Diabetes is a common disease, although the treatment of diabetes is quite diverse, ranging from insulin treatments and blood glucose monitoring to medication and organ or cell transplantation. Generally, all diabetes treatment plans will include a specific diet and exercise regimen to maintain healthy blood sugar levels. When diet, exercise, insulin treatment and medication fail, the next step is to consider a pancreas or islet transplant.

    A pancreas transplant is an effective procedure that can enable someone with type 1 diabetes to become insulin independent. In an overwhelming majority of the cases, the recipient also receives a kidney transplant either simultaneously or preceding the pancreatic transplant. Also, islet cell transplantation is an experimental procedure available for type 1 diabetics.

    For the transplant, islet cells are harvested from a deceased organ donor, then purified, washed, and processed for transplantation into a new patient. As an absolute last resort, removal of the pancreas may be an option the patient’s own pancreas is removed and the cells are purified and placed back into the body in an autologous islet cell transplant. This method does not require the patient to take immunosuppressive drugs and shows promise for insulin independence, though the results may not be permanent.



Page last updated: 1/6/2014 3:04:38 PM