Evidence map›Paper›PMID 42053924›Full record

ArticleClinical transplantation2026

Hypoglycemia Occurrence and Risk Factors in Insulin Independent Patients After Total Pancreatectomy With Islet Autotransplantation.

Azza Hassaan, Anne Eaton, Niveditha Jagadesh, Guru Trikudanathan, Martin Freeman, Elissa Downs, Srinath Chinnakotla, David Martin, Karthik Ramanathan, Gregory J Beilman and 1 more

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Article in Clinical transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Azza HassaanDepartment of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Anne EatonDivision of Biostatistics and Health Data Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0001-5900-9745
Niveditha JagadeshDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0009-0009-8804-6815
Guru TrikudanathanDepartment of Internal Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0003-3661-4496
Martin FreemanDepartment of Internal Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0003-3383-5269
Elissa DownsDepartment of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0001-5145-6903
Srinath ChinnakotlaDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-5443-1258
David MartinDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Karthik RamanathanDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0009-0005-7542-3969
Gregory J BeilmanDepartment of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0001-5036-3027
Melena D BellinDepartment of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-7324-4837

Funding

the NIDDK
6 · The paper itself

Abstract

backgroundTotal pancreatectomy with islet auto-transplantation (TPIAT) alleviates pain and preserves islet function in patients with severe pancreatitis. Although approximately one third of recipients achieve insulin independence, spontaneous hypoglycemia has been observed in this population. Its frequency, risk factors, and management remain poorly characterized.

methodsUsing prospectively collected data on insulin-independent (TPIAT) recipients at the University of Minnesota (2010-2023), we compared patients who developed hypoglycemia (defined as documented blood glucose < 70 mg/dL) to those with no reported hypoglycemia. Demographic, clinical, surgical, and metabolic variables were evaluated, and treatment strategies were reviewed.

resultsAmong 503 TPIAT recipients, 156 (31%) achieved insulin independence; of these, 45 (28.8%) experienced hypoglycemia, including 32 (20.5%) with level 2 hypoglycemia (< 54 mg/dL). Severe hypoglycemia events requiring external assistance occurred in 25% of affected individuals. Hypoglycemia developed a mean of 2.4 ± 2.2 years posttransplant, most commonly postprandial or exercise-related. Patients who developed hypoglycemia were older at the time of TPIAT (p = 0.036) and had higher preoperative BMI (p = 0.016) and a greater prevalence of malabsorptive disorders (p < 0.001), whereas islet yield and metabolic testing results were similar between patients with and without hypoglycemia. Most patients with hypoglycemia (78%) were managed with non-pharmacological interventions (dietary, continuous glucose monitoring); pharmacologic therapies included acarbose (22%), diazoxide (13%), and minidose glucagon (7%).

conclusionsSpontaneous hypoglycemia is a frequent, clinically relevant complication among insulin-independent TPIAT recipients. Older age, higher BMI, and malabsorptive disorders were associated with increased susceptibility. Routine surveillance, dietary counseling, and continuous glucose monitoring (CGM) are common components of management.

Indexed as

HypoglycemiaInsulinIslets of Langerhans TransplantationPancreatectomyPostoperative ComplicationsAdultBlood GlucoseFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProspective StudiesRisk FactorsTransplantation, AutologousBlood GlucoseInsulinacute pancreatitisautoisletautotransplantchronic pancreatitisdiabetesIATpancreatitisTPIATtype 3c diabetes

Identifiers

PMID42053924
PMCPMC13127559

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.