Objective: Successful simultaneous pancreas-kidney transplantation (SPK) in Type 1 diabetic (T1DM) patients results in improved cardiovascular outcome and survival. However, it is doubtful whether the impairment of cardiovascular and endothelial function in T1DM can be completely reversed.
Methods: Pulse-wave velocity, stroke volume, heart rate, serological markers of endothelial dysfunction (soluble intercellular, vascular cell-adhesion molecules, E-selectin, and plasminogen-activator-inhibitor-1) were measured in 10 T1DM patients after SPK with non-diabetic glucose levels, 10 T1DM patients with poor [T1DM>8; glycated haemoglobin (HbA1c)>8%], and 10 with good glucose control (T1DM<7, HbA1c<7%), in 6 non-diabetic patients after kidney transplantation (KT) and 9 non-diabetic control subjects (CON), matching for major anthropometric characteristics.
Results: Pulse-wave velocity was increased in SPK (P < 0.02 vs. CON, KT, T1DM<7) and in T1DM>8 (P < 0.02 vs. T1DM<7). Systolic blood pressure was increased in SPK (P < 0.05 vs. CON). Stroke volume was reduced in SPK, T1DM>8 and T1DM<7 and KT (P < 0.01 vs. CON). Heart rate was elevated in SPK and in T1DM>8 (P < 0.0003 vs. CON and T1DM<7). In SPK, soluble intercellular and vascular cell-adhesion molecules were 100% and 44% higher (P < 0.03 vs. CON), respectively, while plasminogen-activator-inhibitor-1 was decreased in SPK (P < 0.02 vs. CON).
Conclusion: T1DM patients after SPK experience arterial stiffness, a higher heart-rate and blood pressure, reduced stroke volume and serological signs of endothelial dysfunction. Thus, functional and structural cardiovascular alterations as a result of glucotoxicity, uraemia and hypertension in T1DM might not be completely resolved by SPK.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1464-5491.2009.02817.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Diabetic Ketoacidosis in Pregnancy: A Systematic Review of the Reported Cases.
Clin Med Insights Endocrinol Diabetes
January 2025
Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, UK.
Background: Diabetic ketoacidosis (DKA) is a rare but serious complication that can develop during pregnancy, with up to 30% of patients presenting with euglycemia, making prompt recognition challenging. It is associated with increased perinatal mortality rates, although the exact risk of maternal mortality remains unclear. The purpose of this systematic review was to examine the available literature and provide an overview of reported cases of DKA during pregnancy.
View Article and Find Full Text PDFThe effects of type 1 and type 2 diabetes mellitus on bone health in chronic kidney disease.
Nat Rev Endocrinol
January 2025
Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia.
Fracture is an under-recognized but common complication of diabetes mellitus, with an incidence approaching twofold in type 2 diabetes mellitus (T2DM) and up to sevenfold in type 1 diabetes mellitus (T1DM) compared with that in the general population. Both T1DM and T2DM induce chronic hyperglycaemia, leading to the accumulation of advanced glycosylation end products that affect osteoblast function, increased collagen crosslinking and a senescence phenotype promoting inflammation. Together with an increased incidence of microvascular disease and an increased risk of vitamin D deficiency, these factors reduce bone quality, thereby increasing bone fragility.
View Article and Find Full Text PDFIntestinal glucagon-like peptide-1: A new regulator of impaired counterregulatory responses to hypoglycemia in type 1 diabetes mellitus.
World J Diabetes
January 2025
Department of Gastroenterology, The First People's Hospital of Foshan, Foshan 528000, Guangdong Province, China.
In this article, we review the study by Jin , which examined the role of intestinal glucagon-like peptide-1 (GLP-1) in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus (T1DM). With the global rise of T1DM, there is an increased burden on society and healthcare systems. Due to insulin therapy and islet dysfunction, T1DM patients are highly vulnerable to severe hypoglycemia, a leading cause of mortality.
View Article and Find Full Text PDFDemographic and Clinical Characteristics of Patients With Charcot Neuro-Osteoarthropathy in People With Diabetes Mellitus in Six Countries: A Multicenter Observational Study From 1996 to 2022.
J Diabetes Res
January 2025
First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
To describe the demographic and clinical characteristics of patients with Charcot neuro-osteoarthropathy (CNO) and to examine for differences between participants with Type 1 diabetes mellitus (DM) (T1DM) and Type 2 diabetes mellitus (T2DM). Multicenter observational study in eight diabetic foot clinics in six countries between January 1, 1996, and December 31, 2022. Demographic, clinical, and laboratory parameters were obtained from the medical records.
View Article and Find Full Text PDFInterpreting positive celiac serology in children with new-onset type 1 diabetes.
J Pediatr Endocrinol Metab
January 2025
Division of Gastroenterology, Hepatology, & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Objectives: The association of celiac disease (CD) in type 1 diabetes mellitus (T1DM) is well-established, yet variation exists in screening practices. This study measures the accuracy of early screening with tissue transglutaminase Immunoglobulin A (TTG-IgA) and endomysial antibody (EMA) in newly diagnosed T1DM.
Methods: This is a retrospective study of children with T1DM between 2013 and 2019 with early CD screening and follow-up.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!