Diabetes mellitus is associated with a chronic loss of skeletal muscle and bone mass, accompanied by an increase in adipose tissue – sarcopenic obesity. Sarcopenia is associated with poor outcomes in liver resection and transplants. There is no such data in pancreas transplant patients.

Method: A 1:1 case-control study was designed to compare pre pancreas transplant patients (n=22) with healthy controls selected from trauma database with an injury severity score <10, who received an abdominal CT scan. Cases and controls were matched for age, gender, and BMI. Analysis of nutrition status included patient serum albumin and protein levels, and previously validated measures of muscle mass, visceral and subcutaneous fat stores.

Results: The mean duration of DM for study patients was 24 years. DM patients had 18% lower muscle mass (p=0.06) than controls. DM patients had a deficit of subcutaneous fat (p=0.20, 17% deficit), but little difference in visceral fat. The group with the greatest muscle deficit were those patients with DM for greater than 20 years (-34%, compared to -16% (< 10 years) and -12% (10 to 20 years). Patients younger than age 40 had a 34% muscle deficit, which was worse than older patients (-19% (40-49 years) and -12% (50 and older)).

Conclusions: DM patients maintain similar BMI and serum protein levels when compared to controls, but have sarcopenic obesity. Patients at highest risk are those who are younger and have had DM longer.

CITATION INFORMATION: Nagaraju S., Mangus R., Salisbury T., Bush W., Davis J., Powelson J., Fridell J. Objective Measures of Nutrition in Pre-Pancreas Transplant Patients with Type I Diabetes Am J Transplant. 2017;17 (suppl 3).

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