Patients with type 1 diabetes who undergo pancreas transplantation achieve vascular improvements which indicate a reduction in their risk for cardiovascular disease-related events. Dr. Jennifer Larsen of the University of Nebraska Medical Center, Omaha and colleagues analyzed carotid intimal thickness in 25 successful recipients of pancreas transplants. Such thickness, they point out has been shown to correlate with cardiovascular risks and events.
These findings were compared with those in 20 patients with type 1 diabetes but without significant nephropathy, 16 nondiabetic patients who had received kidney transplants, and 32 normal controls.
After pancreas transplantation, patients’ hemoglobin A1c levels returned to normal. Their creatinine levels also fell but were still higher than normal. However, by 1.8 years after transplant, carotid intimal medial thickness had decreased and was no longer different from normal controls.
There was no significant post-transplant change in blood pressure, body mass index, fasting lipid levels, or use of hypolipidemic agents.
Despite the beneficial effects on glucose and neuropathy and nephropathy after transplant, the researchers observe, “cardiovascular disease events remain the primary cause of mortality in patients with type 1 diabetes and end-stage renal disease.”
“This study,” they conclude, “suggests that cardiovascular disease risk, future events, and mortality should improve after pancreas transplantation in the absence of other significant, untreated cardiovascular disease risk factors.” Diabetes Care 2004;27:1706-1711.
DID YOU KNOW:
As of mid-2004, only one study has evaluated the association of statin therapy with open-angle glaucoma. In this case control study, patients who received statins compared with those who did not had a lower risk of glaucoma (p=0.04). Patients who took a statin for 24 or more months appeared to have the greatest benefit (OR 0.60, 95% CI 0.39-0.92). Beneficial effects on glaucoma risk were also seen in patients taking other lipid-lowering therapies.
Arch Ophthalmol 2004;122:822-826.