SURGICAL TREATMENT FOR TYPE 1 DIABETES
胰臟及胰島移植
第一型DM患者, 經成功移植胰臟及胰島細胞可以讓血糖正常化, 減輕小血管併發症
Pancreas and Islet Transplantation
Successful pancreas and islet transplantation can normalize glucose levels and mitigate microvascular complications of type 1 diabetes.
但接受移植的患者需要終身免疫抑制治療, 以避免排斥反應, 或免疫性胰島破壞再發.
However, patients receiving these treatments require life-long immunosuppression to prevent graft rejection and/or recurrence of autoimmune islet destruction.
考量免疫抑制治療前在的不良反應, 胰臟移植僅限於第一型DM患者, 做腎臟移植時同步進行, 或接受過腎臟移植, 或酮酸中毒再發, 或嚴重低血糖
Given the potential adverse effects of immunosuppressive therapy, pancreas transplantation should be reserved for patients with type 1 diabetes undergoing simultaneous renal transplantation, following renal transplantation, or for those with recurrent ketoacidosis or severe hypoglycemia despite intensive glycemic management (32).
隨著持續血糖監控的改善, 封閉式幫浦感應系統, 以及能提供無低血糖警覺性的病患另一種策略的裝置, 單純胰臟及胰島細胞移植的角色, 需要重新思考.
With the advent of improved continuous glucose monitors, closed-loop pump-sensor systems, and devices that offer alternative approaches for patients with hypoglycemia unawareness, the role of pancreas transplantation alone, as well as islet transplant, will need to be reconsidered.
但接受移植的患者需要終身免疫抑制治療, 以避免排斥反應, 或免疫性胰島破壞再發.
However, patients receiving these treatments require life-long immunosuppression to prevent graft rejection and/or recurrence of autoimmune islet destruction.
考量免疫抑制治療前在的不良反應, 胰臟移植僅限於第一型DM患者, 做腎臟移植時同步進行, 或接受過腎臟移植, 或酮酸中毒再發, 或嚴重低血糖
Given the potential adverse effects of immunosuppressive therapy, pancreas transplantation should be reserved for patients with type 1 diabetes undergoing simultaneous renal transplantation, following renal transplantation, or for those with recurrent ketoacidosis or severe hypoglycemia despite intensive glycemic management (32).
隨著持續血糖監控的改善, 封閉式幫浦感應系統, 以及能提供無低血糖警覺性的病患另一種策略的裝置, 單純胰臟及胰島細胞移植的角色, 需要重新思考.
With the advent of improved continuous glucose monitors, closed-loop pump-sensor systems, and devices that offer alternative approaches for patients with hypoglycemia unawareness, the role of pancreas transplantation alone, as well as islet transplant, will need to be reconsidered.
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