Health After TPIAT

Keeping blood glucoses ("blood sugar") near normal is important for two reasons:

1. For those who have a successful islet transplant, keeping blood glucoses well controlled can actually help the islets live and function longer. This is the reason that we often target tighter (more normal) blood sugars after TPIAT than in other routine forms of diabetes like type 1 and type 2 diabetes. 
2. Keeping your blood glucose in a near normal range reduces the risk of developing any diabetes complications long-term.   Researchers at the University of Minnesota are currently studying the risk of diabetes complications 5-20 years after a TPIAT in a study called "LIFT" funded by the National Institutes of Health.

Your specific goals for blood sugar control should be discussed with your physician after surgery. In general, we try to maintain most blood glucoses around 80-120 mg/dL in the hospital, and most of the time 70-140 mg/dL in the first couple of months after surgery. You will receive education in monitoring blood sugar with a meter or continuous glucose monitor, and how to give insulin by shots or an insulin pump. 

After TPIAT, you will not have any digestive pancreas function. It is very important to take pancreatic enzymes (pills) with every meal to digest protein and fat normally. Many people will have symptoms like greasy stools, frequent loose stools, or bloating/gas if they are not getting enough enzymes. Even with pancreatic enzymes, absorption of certain vitamins like vitamin D, E, A, and K may not be normal. To make sure you maintain healthy vitamin levels, we recommend taking a multivitamin every day. A vitamin made for people without a pancreas is the best option-- these come under various brands like MVW, ADEKs, and DEKAs.

Some individuals may not absorb other vitamins and iron as well after surgery because of changes in the intestinal anatomy with surgery. We may recommend additional vitamins or iron supplementation depending on lab results.

We recommend having nutritional labs checked at 3 months, 6 months, 1 year and then yearly after surgery. Your TPIAT team can provide you and your doctor with a copy of the recommended lab orders.

Because most people have their spleen removed with the TPIAT surgery, it is very important that all your doctors know that you don't have a spleen. You will need vaccines before surgery, and boosters after surgery for specific pneumonia and meningitis causing bacteria. If you have a fever (usually 100.5 or 101 or higher), you need to be seen.