Extreme subcutaneous, intramuscular and inhaled insulin resistance treated by pancreas transplantation alone
| Autor: | E.B. Rangel, Cláudio S. Melaragno, M. A. Gabbay, Marcelo Moura Linhares, S. A. Dib, M. A. Alvarenga, V. Tonetto-Fernandes, J. O. Medina Pestana, Alcides Salzedas, João R. Sá, Adriana K. Carmona, Adriano Miziara Gonzalez |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Diabetic ketoacidosis Adolescent medicine.medical_treatment Injections Subcutaneous Pancreas transplantation Gastroenterology Injections Intramuscular Insulin resistance Fatal Outcome Internal medicine Diabetes mellitus Administration Inhalation medicine Immunology and Allergy Humans Insulin Pharmacology (medical) Transplantation Type 1 diabetes business.industry medicine.disease Shock Septic Surgery Diabetes Mellitus Type 1 Pancreatitis Female Pancreas Transplantation Insulin Resistance business |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 10(1) |
| ISSN: | 1600-6143 |
| Popis: | Diabetes mellitus with resistance to insulin administered subcutaneously or intramuscularly (DRIASM) is a rare syndrome and is usually treated with continuous intravenous insulin infusion. We present here two cases of DRIASM in 16 and 18 years female patients that were submitted to pancreas transplantation alone (PTA). Both were diagnosed with type 1 diabetes as young children and had labile glycemic control with recurrent episodes of diabetic ketoacidosis. They had prolonged periods of hospitalization and complications related to their central venous access. Exocrine and endocrine drainages were in the bladder and systemic, respectively. Both presented immediate graft function. In patient 1, enteric conversion was necessary due to reflux pancreatitis. Patient 2 developed mild postoperative hyperglycemia in spite of having normal pancreas allograft biopsy and that was attributed to her immunosuppressive regimen. Patient 1 died 9 months after PTA from septic shock related to pneumonia. In 8 months of follow-up, Patient 2 presented optimal glycemic control without the use of antidiabetic agents. In conclusion, PTA may be an alternative treatment for DRIASM patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text