No Pancreas? You Can Control Diabetes

Type 1 diabetes and insulin levels can be controlled in patients without a pancreas

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Your pancreas is the organ that makes insulin - a hormone that plays a key role in diabetes control. Without a pancreas, controlling diabetes could be difficult; at least that's what doctors thought.

It still may be possible to control type 1 diabetes in patients who have had their entire pancreas removed because of cancer.

"Keep a close eye on your blood sugar to control diabetes."

In many cases, surgeons do not remove the entire pancreas from someone with pancreatic cancer. They take out the affected part of the pancreas so that patients still have some organ function.

However, leaving part of the pancreas can put patients at risk of developing hard-to-detect cancer in the leftover part the organ.

In a recent study, Michael B. Wallace, MD, of the Mayo Clinic in Florida, and colleagues wanted to see how well patients could control diabetes after having their entire pancreas removed.

The pancreas makes insulin to remove sugar from the blood. When the pancreas is removed, patients need insulin from another source like an external pump or through injections.

Patients who have had their pancreas removed can develop type 1 diabetes.

Dr. Wallace and colleagues compared insulin and blood sugar control between 14 patients without a pancreas and 100 type 1 diabetes patients.

They found that both groups had little trouble controlling their blood sugar levels. Neither group had complications.

According to Dr. Wallace, these findings suggest removing the entire pancreas fairly safe and effective.

For years, doctors and surgeons have feared that removing the entire pancreas for cancer and precancerous cysts could make it hard for patients to control the resulting diabetes, said Dr. Wallace.

"Most surgeons try to leave as much of the pancreas as possible," he said.

"What we have shown here is that, due to wonderful recent improvements in insulin therapy, patients without a pancreas can control their blood sugar as effectively as type 1 diabetes patients can," he said.

Even though this study was small, Dr. Wallace said he has seen similar results in patients treated at Mayo Clinic.

"Most surgeons today make difficult decisions about how much of the pancreas to remove in a patient, but that process may become a little more straightforward now that we have demonstrated patients do well when their entire pancreas is removed," Dr. Wallace said.

The study, which was funded by Mayo Clinic, was published in the journal HPB Surgery.

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Review Date: 
August 29, 2012
Last Updated:
September 4, 2012