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Surgical Procedures for Type 1 Diabetes

Generally, type 1 diabetes is managed with insulin therapy, diet, and exercise. However, in some cases, transplant of the pancreas or islet cells might be an option.

Pancreas Transplant

A pancreas transplant may be done if you:

  • Have developed severe renal disease especially if you may need a kidney transplant
  • Have tried insulin treatment, but it has failed to prevent acute complications, like diabetic ketoacidosis
  • Have severe emotional problems due to insulin treatment
  • Have frequent, potentially life-threatening complications, particularly hypoglycemia

Kidney damage is a common complication of type 1 diabetes. Many people with diabetes end up with kidney failure that requires regular dialysis. In most cases, a pancreas transplant is done along with a kidney transplant. There is good evidence that quality of life significantly improves if these 2 transplants are done together.

Some doctors, though, do transplant only the pancreas. This is done in cases where the patient does not have kidney failure. Compared to pancreas-kidney transplant, the benefits of just a pancreas transplant are not as clear.

If you receive 1 or more transplanted organs, you will need to take immunosuppressive drugs for the rest of your life. These drugs prevent the immune system from attacking your new organ. However, these drugs have many severe side effects, including high blood pressure, hyperglycemia, hearing loss, nausea, gastric ulcers, and bacterial and viral infections. Some of these drugs may increase your blood sugar level.

Islet Cell Transplant

Islets are cells located in the pancreas. Only a small percentage of the pancreas is made of these islet cells, which include alpha cells that produce glucagon and beta cells that produce insulin. During the procedure, islet cells are taken from a donor and, using a catheter (small plastic tube), are transplanted to the blood of a person with type 1 diabetes.

This procedure is still being studied. Researchers have found that the beta cells are very fragile. Many of these cells may not survive long-term. In addition, the immunosuppressive drugs seem to impair the insulin-producing ability of the new cells and cause side effects.

There has been some promising research, though. For example, people who have had an islet cell transplant may have better blood sugar control, and some may even be able to stop their daily insulin injections.

Islet Cells

Copyright © Nucleus Medical Media, Inc.

References:

Causes of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Accessed September 7, 2017.
Diabetes mellitus type 1. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 31, 2017. Accessed September 7, 2017.
Harlan DM, Kenyon NS, Korsgren O, Roep BO, Immunology of Diabetes Society. Current advances and travails in islet transplantation. Diabetes. 2009;58(10):2175-2184.
Nathan DM. Isolated pancreas transplantation for type 1 diabetes: a doctor's dilemma. JAMA. 2003;290(21):2861-2863.
Pancreatic islet transplantation. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Updated September 2013. Accessed September 7, 2017.
Type 1 diabetes. American Diabetes Association website. Available at:
...(Click grey area to select URL)
Accessed September 7, 2017.
Last reviewed September 2017 by EBSCO Medical Review Board James P. Cornell, MD
Last Updated: 9/17/2014

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