Autotransplantation of islets in the prevention of hypoglycemia after total pancreatectomy

Czech version

Authors: Peter Girman
Authors‘ workplace: Klinika diabetologie, Centrum diabetologie, IKEM, Praha
Published in: Forum Diab 2024; 13(3): 138-142
Category: Review Article

Overview

Pancreaticobiliary diabetes is a secondary form with the same prevalence in the European population as type 1 diabetes mellitus. The most common cause is chronic pancreatitis, with which resection procedures are closely related. An extremely labile form is diabetes after total pancreatectomy. This type of diabetes is characterized by frequent occurrence of hypoglycemia and even severe episodes. An effective prevention of diabetes is islet autotransplantation, which has been performed since 1980. This treatment effectively prevents diabetes in one third of patients and significantly reduces the incidence of hypoglycemia in the remaining patients. If this procedure cannot be performed, it is advisable to monitor patients with sensors and try to treat them with hybrid loops.

Keywords:

Pancreatectomy – hypoglycemia – autotransplantation – islets

Sources

Ewald N, Bretzel RG. Diabetes mellitus secondary to pancreatic diseases (Type 3c) – are we neglecting an important disease? Eur J Intern Med 2013; 24(3): 203–206. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ejim.2012.12.017>.

Malka D, Hammel P, Sauvanet A et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology 2000; 119(5): 1324–1332. Dostupné z DOI: <http://dx.doi.org/10.1053/gast.2000.19286>.

Hutchins RR, Hart RS, Pacifico M et al. Long-term results of distal pancreatectomy for chronic pancreatitis in 90 patients. Ann Surg 2002; 236(5): 612–618. Dostupné z DOI: <http://dx.doi.org/10.1097/00000658–200211000–00011>.

Burkhart RA, Gerber SM, Tholey RM et al. Incidence and severity of pancreatogenic diabetes after pancreatic resection. J Gastrointest Surg 2015; 19(2): 217–225. Dostupné z DOI: <http://dx.doi.org/10.1007/s11605–014–2669-z>.

Beger HG, Mayer B, Vasilescu C et al. Long-term Metabolic Morbidity and Steatohepatosis Following Standard Pancreatic Resections and Parenchyma-sparing, Local Extirpations for Benign Tumor: A Systematic Review and Meta-analysis. Ann Surg 2022; 275(1): 54–66. Dostupné z DOI: <http://dx.doi.org/10.1097/SLA.0000000000004757>.

Dai M, Xing C, Shi N et al. Risk factors for new-onset diabetes mellitus after distal pancreatectomy. BMJ Open Diabetes Res Care 2020; 8(2): e001778. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjdrc-2020–001778>.

Kreutzenberg SVD, Maifreni L, Lisato G et al. Glucose Turnover and Recycling in Diabetes Secondary to Total Pancreatectomy: Effect of Glucagon Infusion*. J Clin Endocrinol Metab 1990; 70(4): 1023–1029. Dostupné z DOI: <http://dx.doi.org/10.1210/jcem-70–4-1023>.

Lund A, Bagger JI, Wewer Albrechtsen NJ et al. Evidence of Extrapancreatic Glucagon Secretion in Man. Diabetes 2016; 65(3): 585–597. Dostupné z DOI: <http://dx.doi.org/10.2337/db15–1541>.

Sun EW, Martin AM, de Fontgalland D et al. Evidence for Glucagon Secretion and Function Within the Human Gut. Endocrinology 2021; 162(4): bqab022. Dostupné z DOI: <http://dx.doi.org/10.1210/endocr/bqab022>.

Polonsky KS, Herold KC, Gilden JL et al. Glucose Counterregulation in Patients After Pancreatectomy: Comparison With Other Clinical Forms of Diabetes. Diabetes 1984; 33(11): 1112–1119. Dostupné z DOI: <http://dx.doi.org/10.2337/diab.33.11.1112>.

Del Prato S, Vigili de Kreutzenberg S, Riccio A et al. Insulin-induced hypoglycaemia in patients with diabetes secondary to total pancreatectomy: mechanisms of impaired counterregulation. Diabet Nutr Metab 1990; 3: 111–121.

Parsaik AK, Murad MH, Sathananthan A et al. Metabolic and target organ outcomes after total pancreatectomy: Mayo Clinic experience and meta-analysis of the literature. Clin Endocrinol (Oxf) 2010; 73(6): 723–731. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2265.2010.03860.x>.

Barbier L, Jamal W, Dokmak S et al. Impact of total pancreatectomy: short- and long-term assessment. HPB (Oxford) 2013; 15(11): 882–892. Dostupné z DOI: <http://dx.doi.org/10.1111/hpb.12054>.

Suto H, Kamei K, Kato H et al. Risk factors associated with hypoglycemic events after total pancreatectomy: A nationwide multicenter prospective study in Japan. Surgery 2022; 172(3): 962–967. Dostupné z DOI: <http://dx.doi.org/10.1016/j.surg.2022.04.031>.

Stoop TF, Ateeb Z, Ghorbani P et al. Impact of Endocrine and Exocrine Insufficiency on Quality of Life After Total Pancreatectomy. Ann Surg Oncol 2020; 27(2):587–596. Dostupné z DOI: <http://dx.doi.org/10.1245/s10434–019–07853–3>.

Jamil LH, Chindris AM, Gill KR et al. Glycemic control after total pancreatectomy for intraductal papillary mucinous neoplasm: an exploratory study. HPB Surg 2012; 2012: 381328. Dostupné z DOI: <http://dx.doi.org/10.1155/2012/381328>.

Scholten L, Latenstein AEJ, van Eijck C et al. Outcome and long-term quality of life after total pancreatectomy (PANORAMA): a nationwide cohort study. Surgery 2019; 166(6): 1017–1026. Dostupné z DOI: <http://dx.doi.org/10.1016/j.surg.2019.07.025>.

Sutherland DE, Radosevich DM, Bellin MD et al. Total pancreatectomy and islet autotransplantation for chronic pancreatitis. J Am Coll Surg 2012; 214(4): 409–424. Discussion 424–426. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jamcollsurg.2011.12.040>.

Rickels MR, Bellin M, Toledo FG et al. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012. Pancreatology 2013; 13(4): 336–342. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pan.2013.05.002>.

Balzano G, Maffi P, Nano R et al. Diabetes-free survival after extended distal pancreatectomy and islet auto transplantation for benign or borderline/malignant lesions of the pancreas. Am J Transplant 2019; 19(3): 920–928. Dostupné z DOI: <http://dx.doi.org/10.1111/ajt.15219>.

Robertson RP. Islet transplantation for type 1 diabetes, 2015: what have we learned from alloislet and autoislet successes? Diabetes Care 2015; 38(6): 1030–1035. Dostupné z DOI: <http://dx.doi.org/10.2337/dc15–0079>.

Rickels MR, Fuller C, Dalton-Bakes C et al. Restoration of Glucose Counterregulation by Islet Transplantation in Long-standing Type 1 Diabetes. Diabetes 2015; 64(5): 1713–1718. Dostupné z DOI: <http://dx.doi.org/10.2337/db14–1620>.

Chinnakotla S, Radosevich DM, Dunn TB et al. Long-term outcomes of total pancreatectomy and islet auto transplantation for hereditary/genetic pancreatitis. J Am Coll Surg 2014; 218(4): 530–543. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jamcollsurg.2013.12.037>.

Girman P, Kriz J, Németová L et al. First Czech-Slovak Intercountry Islet Autotransplantation-Brief Case Report. Transplant Direct 2024; 10(1): e1562. Dostupné z DOI: <http://dx.doi.org/10.1097/TXD.0000000000001562>.

Vonderau JS, Williams BM, DeCherney S et al. Use of Continuous Glucose Monitoring for evaluation of hypoglycemia pre- and post-operatively for patients undergoing Total Pancreatectomy with Autologous Islet Cell Transplant. Clin Transplant 2021; 35(11): e14450. Dostupné z DOI: <http://dx.doi.org/10.1111/ctr.14450>.

Juel CTB, Dejgaard TF, Hansen CP et al. Glycemic Control and Variability of Diabetes Secondary to Total Pancreatectomy Assessed by Continuous Glucose Monitoring. J Clin Endocrinol Metab 2021; 106(1): 168–173. Dostupné z DOI: <http://dx.doi.org/10.1210/clinem/dgaa731>.

Labels

Diabetology Endocrinology Internal medicine

2024: hypoglycaemia in focus

Modern technologies in the prevention of hypoglycaemia

Hypoglycemia in patients on hemodialysis with diabetes mellitus

Non-diabetic forms of hypoglycemia in the pediatric population

Specifics of hypoglycemia in the geriatric population

Empagliflozin – moving from secondary prevention to early intervention

Canagliflozin in the treatment of patients with type 2 diabetes mellitus

Article was published in

Forum Diabetologicum

2024 Issue 3