Pancreas–kidney transplantation may reduce fracture risk in men with type 1 diabetes mellitus

2013 ◽  
Vol 9 (3) ◽  
pp. 124-124
Author(s):  
Susan J. Allison
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Kidney Transplantation ◽  
Fracture Risk ◽  
Type 1 Diabetes Mellitus ◽  
Pancreas Kidney Transplantation ◽  
Reduce Fracture Risk

scholarly journals Simultaneous pancreas‐kidney transplantation in type 1 diabetes mellitus. Clinical options

2020 ◽  
Vol 23 (3) ◽  
pp. 275-282
Author(s):  
A. S. Severina ◽  
I. I. Larina ◽  
A. S Shutovа ◽  
M. S. Shamkhalova ◽  
I. V. Dmitriev ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Kidney Transplantation ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Complications ◽  
Pancreas Kidney Transplantation ◽  
Simultaneous Pancreas Kidney ◽  
Stage Renal Disease ◽  
Simultaneous Pancreas Kidney Transplantation

Simultaneous pancreas-kidney transplantation (SPKT) is the most promising treatment option for patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease (ESRD) due to diabetic nephropathy (DN). Successful SPKT eliminates uremic intoxication and hyperglycemia the leading trigger of vascular diabetic complications. Therefore, euglycemia is an important metabolic change in patients after surgery and remains only one of the factors for the saved renal allograft functioning. In the case of resuming renal replacement therapy by dialysis after SPKT, the management and monitoring of the pancreatic graft remains open. Special attention to the pancreatic grafts function is due to both the potential risk of surgical complications, and some probability of T1DM relapse with the need to resume insulin therapy. In patients with saved function of both transplants, the assessment of the dynamics of diabetic complications in general becomes more important. The results of few studies in this regard remain contradictory. Thus, clinical options can be unpredictably diverse and require not only search for the root cause, but also optimization of rehabilitation tactics, even if the expected results are achieved.

scholarly journals Simultaneous islet–kidney vs pancreas–kidney transplantation in type 1 diabetes mellitus: a 5 year single centre follow-up

Diabetologia ◽  
2007 ◽  
Vol 51 (1) ◽  
pp. 110-119 ◽  
Author(s):  
P. A. Gerber ◽  
V. Pavlicek ◽  
N. Demartines ◽  
R. Zuellig ◽  
T. Pfammatter ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Kidney Transplantation ◽  
Type 1 Diabetes Mellitus ◽  
Single Centre ◽  
Pancreas Kidney Transplantation

Pancreas Islet Transplantation in Patients With Type 1 Diabetes Mellitus After Kidney Transplantation

2005 ◽  
Vol 37 (3) ◽  
pp. 1443-1445 ◽  
Author(s):  
M. Gonzalez Molina ◽  
A. Alonso ◽  
R. Briones ◽  
N. Fernandez ◽  
A. Caballero ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Kidney Transplantation ◽  
Type 1 Diabetes Mellitus ◽  
Islet Transplantation ◽  
Pancreas Islet

scholarly journals Recurrent vertebral fractures in a young adult: a closer look at bone health in type 1 diabetes mellitus

2018 ◽  
Vol 2018 ◽  
Author(s):  
Eleanor P Thong ◽  
Sarah Catford ◽  
Julie Fletcher ◽  
Phillip Wong ◽  
Peter J Fuller ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Fracture Risk ◽  
Type 1 Diabetes Mellitus ◽  
Vertebral Fractures ◽  
Bone Health ◽  
Bone Microarchitecture ◽  
List Type ◽  
Secondary Fracture

Summary The association between type 1 diabetes mellitus (T1DM) and bone health has garnered interest over the years. Fracture risk is known to be increased in individuals with T1DM, although bone health assessment is not often performed in the clinical setting. We describe the case of a 21-year-old male with longstanding T1DM with multilevel vertebral fractures on imaging, after presenting with acute back pain without apparent trauma. Dual-energy X-ray absorptiometry (DXA) revealed significantly reduced bone mineral density at the lumbar spine and femoral neck. Extensive investigations for other secondary or genetic causes of osteoporosis were unremarkable, apart from moderate vitamin D deficiency. High-resolution peripheral quantitative computed tomography and bone biospy revealed significant alterations of trabecular bone microarchitecture. It later transpired that the patient had sustained vertebral fractures secondary to unrecognised nocturnal hypoglycaemic seizures. Intravenous zoledronic acid was administered for secondary fracture prevention. Despite anti-resorptive therapy, the patient sustained a new vertebral fracture after experiencing another hypoglycaemic seizure in his sleep. Bone health in T1DM is complex and not well understood. There are significant challenges in the assessment and management of osteoporosis in T1DM, particularly in young adults, where fracture prediction tools have not been validated. Clinicians should be aware of hypoglycaemia as a significant risk factor for fracture in patients with T1DM. Learning points: Type 1 diabetes mellitus (T1DM) is a secondary cause of osteoporosis, characterised by reduced bone mass and disturbed bone microarchitecture. Hypoglycaemic seizures generate sufficient compression forces along the thoracic column and can cause fractures in individuals with compromised bone quality. Unrecognised hypoglycaemic seizures should be considered in patients with T1DM presenting with fractures without a history of trauma. Patients with T1DM have increased fracture risk and risk factors should be addressed. Evaluation of bone microarchitecture may provide further insights into mechanisms of fracture in T1DM. Further research is needed to guide the optimal screening and management of bone health in patients with T1DM.

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