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Metabolic control and progression of complications in insulin‐dependent diabetic patients after kidney transplantation
Author(s) -
EKSTRAND A.,
GROOP L.,
PETTERSSON E.,
GRÖNHAGENRISKA C.,
LAATIKAINEN L.,
MATIKAINEN E.,
SEPPÄLÄINEN A.M.,
LAASONEN E.,
SUMMANEN P.,
OLLUS A.,
AHONEN J.
Publication year - 1992
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1992.tb00580.x
Subject(s) - medicine , transplantation , diabetes mellitus , kidney transplantation , kidney , surgery , retinopathy , diabetic retinopathy , complication , endocrinology
Patient survival and progression of complications were monitored for 3 years after kidney transplantation in 29 type‐1 diabetic patients. Ten age‐matched, non‐diabetic kidney‐transplanted patients served as controls. Five diabetic patients died during follow‐up (three cardiovascular events, two infections), three diabetic patients had a non‐fatal myocardial infarction and four developed cerebrovascular complications after transplantation. Of the diabetic patients, 69% suffered from proliferative retinopathy before transplantation; 20% of them improved, 65% remained unchanged and 15% deteriorated after transplantation. Motor but not sensory conduction velocity measured from the nervus medianus improved after transplantation. Autonomic neuropathy was observed in 50% of the patients and was unaffected by transplantation. Glycaemic control did not improve significantly during follow‐up (HbA 1 , 10.6 ± 0.5% before and 9.5 ± 0.6% 3 years after transplantation). Body weight increased in both diabetic and non‐diabetic patients within 3 years after transplantation (from 68 ± 2 to 77 ± 6 kg in diabetics, P < 0.01; from 167 ± 4 to 77 ± 6 kg in non‐diabetics, P < 0.01). Subcutaneous fat thickness measured from computer tomography scans of the calf increased in diabetic patients from 5.0 ± 0.6 to 6.1 ± 0.9 mm ( P < 0.05). However, the cross‐sectional areas of triceps and calf muscles did not increase, suggesting that the increase in body weight was solely due to an increase in fat. It is clear that diabetes‐related complications continue to progress and are not influenced by a successful kidney transplant.