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Title: Extreme Subcutaneous, Intramuscular and Inhaled Insulin Resistance Treated by Pancreas Transplantation Alone
Authors: Sá, J. R. [UNIFESP]
Alvarenga, Marcelo A. [UNIFESP]
Rangel, Erika B. [UNIFESP]
Melaragno, Claudio S. [UNIFESP]
Gonzalez, Adriano M. [UNIFESP]
Linhares, Marcelo Moura [UNIFESP]
Salzedas, A. [UNIFESP]
Carmona, Adriana K. [UNIFESP]
Tonetto-Fernandes, Vania [UNIFESP]
Gabbay, Monica Andrade Lima [UNIFESP]
Pestana, Jose Osmar Medina [UNIFESP]
Dib, Sergio Atala [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Hosp Infantil Darcy Vargas
Keywords: Diabetes mellitus
insulin resistance
pancreas transplantation alone
Issue Date: 1-Jan-2010
Publisher: Wiley-Blackwell
Citation: American Journal of Transplantation. Malden: Wiley-Blackwell Publishing, Inc, v. 10, n. 1, p. 184-188, 2010.
Abstract: 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.
ISSN: 1600-6135
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Appears in Collections:Em verificação - Geral

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