DEAR MAYO CLINIC: My wife is 31 and was diagnosed with type 1 diabetes at age 7. She had a baby three months ago, and her blood sugar levels were never really controlled. Doctors tested her kidney function and said there is “a little damage” but nothing to worry about. They said a pancreas transplant might be an option. How risky is this? What medications will she need to take following the transplant?
ANSWER: Most patients with type 1 diabetes do not require a pancreas transplant, because newer insulin regimens can keep their blood sugar under control. However, someone in your wife’s situation should consider a pancreas transplant, especially if she has frequent “insulin reactions” — meaning her blood sugar goes very low without her realizing it. A pancreas transplant could fix the problems with her blood sugar control and prevent further injury to her kidneys.
As with all transplants, a pancreas transplant is major surgery. Afterward, your wife will need to take drugs to keep her body’s immune system from rejecting the new pancreas. But overall, the risks associated with the transplant are likely to be lower than the risk of long-term organ damage that can result from uncontrolled blood sugar.
If successful, a pancreas transplant can restore the body’s ability to secrete insulin, reducing blood sugar levels and eliminating the need for insulin therapy. Insulin is a hormone. When you eat, the pancreas — a gland located just behind your stomach — releases insulin into your bloodstream. As insulin circulates through your blood, it allows sugar to enter your cells, lowering the amount of sugar in your bloodstream. If your body doesn’t have enough insulin, sugar can build up in your blood. Diabetes is the condition of having too much blood sugar.
People with type 1 diabetes are more likely to benefit from a pancreas transplant than are people who have type 2 diabetes. That’s because a damaged pancreas is usually the main cause of high blood sugar in type 1 diabetes. People with type 2 diabetes often have other factors, beyond the pancreas’s inability to produce enough insulin, contributing to their high levels of blood sugar.