Background Limited data are available on long-term metabolic outcomes of functioning pancreas transplants in patients with type 2 diabetes mellitus (T2DM). The aim of this study is to compare the long-term effects of pancreas transplantation regarding metabolic control and beta-cell function between type 1 diabetes mellitus (T1DM) and T2DM.

Methods Among 187 consecutive patients who underwent pancreas transplantation in our center from August, 2004 through June, 2014, 167 patients (115 T1DM and 52 T2DM) were included in this study. Comparisons were performed between T1DM and T2DM patients from post-transplant 1 month to 7 years using generalized linear mixed models for repeated measures.

Results T1DM patients were significantly younger than T2DM patients (33±8 vs. 46±9 years old; p<0.001) however, body mass index was not different between groups (20.7±2.3 vs. 21.5±2.6; p=0.062). In T2DM patients, 27 simultaneous pancreas-kidney (SPK), 15 pancreas after kidney (PAK) transplantations, 4 pancreas transplantation alone (PTA), and 6 simultaneous pancreas and living donor kidney (SPLK) transplantations were performed while 44 SPK, 12 PAK, 45 PTA, and 14 SPLK were performed in T1DM patients. Throughout the follow up, HbA1c was significantly lower in T2DM patients compared with T1DM patients (p=0.018) while C-peptide was significantly higher in T2DM patients (p<0.001). Meanwhile, there was no difference in HOMA-IR, HOMA β cell, and insulinogenic index between groups.

Conclusions There were no significant differences in insulin resistance and β cell function after pancreas transplantation between T1DM and T2DM patients. With rather strict selection criteria, pancreas transplantation in T2DM patients is feasible with favorable long-term outcomes in terms of endocrine functions.

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