Women with normal glucose tolerance and a history of gestational diabetes show significant impairment of ß-cell function at normal insulin sensitivity.

OBJECTIVE: Although the nature of gestational diabetes mellitus (GDM) remains unclear, the condition is thought to be related primarily to insulin resistance, overweight and obesity. Most studies include women with a history of GDM and later carbohydrate metabolism abnormalities, while reports of women with previous GDM and subsequent normoglycaemia are scarce. The aim of this study was to assess insulin resistance and ß-cell function in normoglycaemic women with a history of GDM. MATERIALS AND METHODS: The study group included 199 women, aged 38.4±6.6 years, diagnosed with GDM within the last 5-12 years [GDM(+)] and a control group of 50 comparable women in whom GDM was excluded [GDM(-)], according to WHO criteria. Blood glucose and insulin levels were measured at the beginning (fasting) and at 60 and 120min of oral glucose tolerance tests. Indices of insulin resistance (HOMA-IR), insulin sensitivity (HOMA-S%) and ß-cell function (HOMA-B%) were calculated. RESULTS: Normoglycaemia was observed in 57% of GDM(+) and 88% of GDM(-) women (P=0.0003). Diabetes was diagnosed in 13 (6.5%) GDM(+) women and in none of the GDM(-) women. Comparison of 113 normoglycaemic GDM(+) and 44 normoglycaemic GDM(-) women revealed significantly impaired ß-cell function (HOMA-B%: 131.1±51.1 vs 144.7±47.1, respectively; P=0.038) with similar normal body mass index (BMI) and no differences in HOMA-IR and HOMA-S%. CONCLUSION: In this study, more than half of the GDM(+) women were presented with normal glucose tolerance. However, despite normoglycaemia, women with a history of GDM were characterized by significantly impaired insulin secretion, but no signs of increased insulin resistance.

Factors that impact on immediate graft function in patients after renal transplantation.

Kidney transplantation has become therapy of choice for patients with end-stage renal failure. However, many factors may cause graft rejection or delayed graft function, both of which decrease the prognosis for graft survival. For transplantologists the most important endeavor is to eliminate factors responsible for shortening graft function and to find those predictive of immediate graft function. The aim of the study was to investigate which factors influence early graft function. We retrospectively reviewed 442 renal transplant patients performed between 1990 and 1995 in two Szezecin units. All patients received an identical immunosuppressive drug schedule. Three hundred twelve patients who displayed immediate graft function were included in the study group to analyze donor and recipient age and sex, etiology of ESRD, HLA compatibility AB0 and Rh compatibility cold ischemia time, warm ischemia time, antileukocytes antibodies (PRA), and period of dialysis therapy before transplantation. We observed statistical significance for HLA and AB0 compatibility, younger donor age, and shorter cold ischemia time as the most important factors predictive of early graft function and an improved prognosis for graft survival.

Impact of selected factors on early graft function in patients after renal transplantation.

Transplantation is the best treatment for end-stage renal diseases. For transplantologists, it is most important to know the factors that worsen graft survival prognosis. The aim of the study was to investigate factors predictive of graft loss and shortened graft survival. We retrospectively reviewed 442 renal transplant patients between 1990 and 1995 in two Szczecin units, all of whom received a triple-drug immunosuppressive regimen. One hundred thirty patients showed graft disorders such as delayed graft function or primary nonfunction. The occurrence of these disorders was examined as a function of donor and recipient age and sex, cause of ESRD, HLA compatibility, ABO and Rh compatibility, cold ischemia time, warm ischemia time, antileukocyte antibody level (PRA), and period of dialysis therapy before transplantation. The study showed that a high maximal PRA level, incompatibility for ABO group, and a longer warm ischemia time increase the probability of early graft function disorders.

Factors influencing low incidence of living donors for renal transplantation in Poland.

PURPOSE OF THE STUDY: To answer the question: "Why are only 3.8% of kidney transplantations in Poland from living donors?" MATERIAL AND METHODS: The research was conducted using data from anonymous polls addressed to family members of dialyzed patients (potential donors). RESULTS: Almost everybody (98%) had heard about the possibility of treating renal insufficiency by kidney transplantation, but only 77% knew about the possibility of giving their own kidney to a related person. Merely 36% had been informed about this treatment method by a doctor. The most common fears within respondents were those of: health worsening after donating a kidney--45%, and the operation itself (taking an organ)--39%.