Islet amyloid deposits contribute to islet cell dysfunction, loss of islet mass, and ultimately islet cell death. Studies to determine if mutations in the IDE gene are associated with Type 2 diabetes are planned. Using ultrasound measured carotid intima media thickness as a marker of general atherosclerotic vascular disease risk, patients with Type 1 diabetes undergo a carotid ultrasound before and at intervals after successful pancreas transplantation. There is some data to suggest that ApoE gene polymorphisms may also increase risk for developing diabetic nephropathy. Thus, if this is true it might be assumed that amongst pancreas transplant candidates, the ApoE gene polymorphisms would be more common than in well controlled Type 1 diabetes patients or normal patients without diabetes.
Pancreas transplantation can result in normalization of glucose metabolism for months to years.
At any time, pancreas function can fail. The natural history of pancreas function failure after pancreas transplantation has not been well characterized and the multiple potential causes of failure are often not well described or determined. Among possible causes include acute or chronic immune mediated graft rejections including progressive injury from previous episodes, pancreatitis or associated peri-graft infections, recurrent Type 1 diabetes, new onset Type 2 diabetes, and injury from immunosuppressant agents. This prospective evaluation of individuals found to develop unexpected hyperglycemia will try to discern the relative causes of pancreas failure. Changes in islet function and lipid metabolism associated with immunosuppressant agents.