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  • Title: Utility of glucagon stimulation test in type 1 diabetes after pancreas transplantation.
    Author: Hiratsuka I, Suzuki A, Kondo-Ando M, Hirai H, Maeda Y, Sekiguchi-Ueda S, Shibata M, Takayanagi T, Makino M, Fukami N, Itoh T, Sasaki H, Kusaka M, Kenmochi T, Hoshinaga K, Itoh M.
    Journal: Transplant Proc; 2014 Apr; 46(3):967-9. PubMed ID: 24767392.
    Abstract:
    BACKGROUND: Despite recent progress of immunosuppressive therapy with newly developed agents, long-term pancreatic graft survival after pancreas transplantation still remains low. Therefore, precise assessment of β-cell function after pancreas transplantation is necessary. METHODS: Pancreatic β-cell secretory activity was measured by means of the peripheral plasma fasting serum C-peptide (CPR) response to 1 mg of glucagon intravenously in 23 patients after pancreas transplantation. The utility of ΔCPR after injection was compared with other indices that reflect insulin secretion. RESULTS: When we performed the test, 6 patients still needed insulin injection after the transplantation. Mean CPR before and after glucagon intravenously were 1.9 ± 0.98 ng/mL and 4.6 ± 2.29 ng/mL, respectively. Fasting serum CPR, secretory unit of islet in transplantation (SUIT) index, and ΔCPR after glucagon injection were significantly different between insulin users and nonusers. During follow-up (501 ± 228 days), 3 patients could stop using insulin, and their increase of CPR (1.8 ± 0.5 ng/mL) was significantly higher than that in continuous insulin users (0.3 ± 0.3 ng/mL). CONCLUSION: Fasting CPR, SUIT index, and ΔCPR after glucagon injection could reflect β-cell function for post-pancreas transplant patients, and glucagon stimulation test could give us additional information to predict insulin-free treatment.
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