Preoperative and Postoperative Predictors of Insulin Independence From Total Pancreatectomy and Islet Autotransplantation
Authors' conclusion
Short- and long-term insulin independence after TPIAT is associated with higher transplanted IEQ per kg and immediate postoperative variables that can be used to inform the discussions clinicians have with their patients regarding glycemic prognosis following TPIAT.
Study context
- Population
- Patients undergoing total pancreatectomy and islet autotransplantation (TPIAT), 2010 to 2022, single hospital system
- Participants
- 46 patients
- Exposure
- Insulin-independent vs insulin-dependent patients after TPIAT
- Outcome
- Insulin independence after TPIAT and its preoperative and postoperative predictors
- Follow-up
- 1 year and long-term
Methodological detailssingle hospital system
- Single hospital system
Main finding
As reported in the abstract
Short-term (1 year) insulin independence
9
20%
Long-term insulin independence
7
15%
Observational data: associations, not effects.
Further findings
Transplanted islet equivalents (IEQ) per kg (median), short-term insulin independence · 1 year
- Short-term insulin independence associated with higher median transplanted IEQ per kg
- P = 0.02
Units of basal insulin on discharge, short-term insulin independence · 1 year
- Short-term insulin independence associated with lower units of basal insulin on discharge
- P = 0.009
Discharge with an insulin regimen, short-term insulin independence · 1 year
- Short-term insulin independence associated with lower rates of discharge with an insulin regimen
- P = 0.006
Odds of short-term insulin independence per 1000 increase in IEQ per kg · 1 year
- Odds increased by 80% per 1000 increase in IEQ per kg
- OR 1.80, CI 1.18-3.12, P = .005
Odds of short-term insulin independence per additional basal unit of insulin on discharge · 1 year
- Odds decreased by 32% per additional basal unit of insulin on discharge
- OR 0.68, CI 0.42-0.91, P = .003
Long-term insulin independence and transplanted IEQ per kg · last follow-up after year 1
- Long-term insulin independence also associated with transplanted IEQ per kg
Insulin independence in patients on antihyperglycemic medication before surgery
- Patients on preoperative antihyperglycemic medication achieving insulin independence
- 0
Original publication
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