Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
AIM: The ability to generate a greater insulin response to an oral compared to an intravenous glucose load is the result of pancreatic stimulation by gut hormones and is known as the incretin effect (IE). A diminished IE is seen in diabetes and is associated with abnormal glucose tolerance (GT). We have recently reported that 30% of pancreas transplant subjects have abnormal glucose tolerance post-operatively, despite insulin independence and that this is associated with later graft failure. The incretin effect is thought to be mediated via a neuroendocrine axis and the role of the incretin effect in people receiving a denervated pancreas transplant is unknown. This study aimed to assess the incretin effect after pancreas transplantation
METHOD: The incretin effect was measured with extended frequently-sampled oral glucose tolerance tests and matched isoglycaemic intravenous glucose infusions in 10 pancreas transplant recipients and 10 kidney transplant recipients at 2 weeks and 3 months post-transplant, and in 10 healthy controls.
RESULTS: The groups were comparable for demographics. Isoglycaemia was achieved in each group. The pancreas transplant group at 2 weeks post-transplant showed lower glucose disposal compared to the kidney only transplant group and healthy controls (26.2% vs 42% vs 56.4%), with a significantly diminished incretin effect (7.5% vs 36.9% vs 46.5%, p<0.01) respectively. However, by 3 months, glucose disposal and the incretin effect had improved (26.2%-51.4% and 7.5%-27.4% respectively).
CONCLUSION: The present data suggest, for the first time, that pancreas transplantation may also be associated with a delay in establishing a full incretin effect. Whilst we cannot attribute a causal role, improvement at 3 months may represent re-innervation and future studies including an incretin therapy intervention trial are needed to determine whether incretin based therapies can improve long term pancreas transplant outcomes.
To cite this abstract in AMA style:Mittal S, Franklin R, Sharples E, Knop F, Holst J, Gough S, Friend P. The Role of the Incretin Effect After Pancreas Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-role-of-the-incretin-effect-after-pancreas-transplantation/. Accessed December 1, 2023.
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