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Risk of Glucose Intolerance and Diabetes in Hemipancreatectomized Donors Selected for Normal Preoperative Glucose Metabolism

¹Department of Medicine
²Department of Surgery, University of Minnesota (UMN), Minneapolis, MN

kumar045{at}umn.edu

ABSTRACT

Objective: Hemipancreatectomy (HPx) for the purpose of organ donation has been associated with a 25% risk of developing abnormal glucose tolerance or diabetes in the year following surgery. Since 1997, the University of Minnesota has imposed criteria to prevent potential donors with clinical features associated with an increased diabetes risk from undergoing HPx. We recently assessed glucose tolerance in HPx donors selected since the adoption of the new criteria to determine if the risk of developing abnormal glucose tolerance was reduced below the rate of 25% previously demonstrated.

Research Design and Methods: Individuals who underwent HPx for the purpose of pancreas donation between 1997-2003 were contacted and interviewed about their health status. Those not on diabetes medications were invited to undergo an assessment of their glucose tolerance.

Results: Successful contact was made with 15/21 donors who underwent HPx during this period. Two donors reported use of oral diabetic medications and were not studied further. Of the remaining 13, 2 had impaired fasting glucose (FBG 100-125 mg/dl), 1 had impaired glucose tolerance (2 hr post-glucose load BG 140-199 mg/dl), and 3 displayed both. One donor met diagnostic criteria for diabetes. Six donors had normal glucose values.

Conclusions: Despite the use of stringent criteria to exclude those at risk for developing abnormalities in glucose metabolism, 43% of healthy humans who underwent HPx between 1997-2003 have impaired fasting glucose, impaired glucose tolerance, or diabetes on follow-up. The current preoperative criteria are insufficient to predict those that will develop abnormal glucose metabolism following hemipancreatectomy.

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