Harini A Chakkera
Mayo Clinic, USA
Posters & Accepted Abstracts: J Diabetes Metab
While simultaneous pancreas kidney transplant (SPKTx) is a therapeutic option for patients with type 1 diabetes (T1DM) and renal failure, few centers offer SPKTx to ??select? non-T1DM patients. To address concerns that existing insulin resistance may limit the benefits of the pancreas allograft among non-T1DM we compared several indices of glucose homeostasis, in ??select?, non-T1DM and T1DM patients who received SPKTx. Criteria for ??select? non-T1DM included: Positive C-peptide, BMI <30 kg/m2, treatment with oral agents before insulin initiation and insulin at <1 unit/kg/day. We compared several indices of glucose homeostasis within 1 year post-SPKTx among seven ??select? patients with non-T1DM and nine patients with T1DM with similar age, BMI and immunosuppression. Measurements of insulin resistance included: Homeostatic model, insulin sensitivity index and insulin glucose ratio; insulin secretion measures included: Corrected insulin response. We found non-T1DM had similar pre-transplant metabolic (fasting glucose, HbA1C, blood pressure and lipid) parameters to the T1DM cohort. There were no significant differences in the various measures of insulin resistance and secretion between T1DM and ??select? non-T1DM patients. In conclusion our results suggest SPKTx should be considered in the therapeutic armamentarium among carefully select non-T1DM with features of minimal insulin resistance; however, a larger cohort with longer follow-up is needed to confirm our results.
Harini A Chakkera has completed her MD in India, Internal Medicine Residency training at Hennepin County Medical Center, Minneapolis, MN and subsequently General Nephrology and Transplant Nephrology Fellowship at UCSF, San Francisco, CA. During her Fellowship she has completed her MPH at UC Berkley. She is an Associate Professor of Medicine at Mayo Clinic and practicing Transplant Nephrologist. She is the Medical Director of the Pancreas Transplant Program at Mayo Clinic in Arizona. She is actively involved in epidemiology research, with her expertise being new onset diabetes after transplantation. She has published over 50 peer reviewed manuscripts. She is an active Member and serves on various committees of the American Society of Nephrology and American Society of Transplantation.
Email: chakkera.harini@mayo.edu
