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Pancreas transplantation and diabetic complications.

Hyperglycemia is an important factor in the development and progression of the complications of diabetes mellitus. In this issue of the Journal, Fioretto et al. report that pancreas transplantation reverses the lesions of diabetic nephropathy in patients who have type 1 diabetes without uremia and who become normoglycemic after transplantation.1 Successful transplantation of the pancreas (alone or in combination with a kidney) normalizes glucose homeostasis in patients with type 1 diabetes, but the effect of the graft on diabetic complications is variable.2 It results in improvement in diabetic neuropathy but not diabetic retinopathy. The lack of improvement in retinopathy is . . .