121-OR: Immunosuppressant-Related Quality of Life and Lifestyle of Insulin Independent T1D Pancreas Transplant Recipients

Abstract

Background: Pancreas Transplantation (PT) provides insulin independence and improves quality of life in patients with type 1 diabetes (T1D). However, PT recipients require lifelong immunosuppression resulting in immunosuppression related side-effects. Methods: After IRB approval, we prospectively studied 15 PT recipients at least 1 year after PT. Subjects completed DEXA for body composition, actigraph for 1 week, the modified Transplant symptom occurrence and distress scale (MTSOSD) and VioFFQ - VIOCARE Food Frequency questionnaires. Results: PT recipient were 53.1 ± 10.6 years old, 12F, BMI (Kg/m2) 30.8 ± 6, 33 ± 12.3 years of T1D and 6 ± 5 years (1-17years) time interval from PT. Lab values were HbA1c 5.4 ± 0.6 %, fructosamine 233 ± 27 µmol/L, fasting glucose 94.3 ± 17.5 mg/dl, C-peptide 2.5 ± 0.9 ng/ml and eGFR 56.3 ± 25.5 ml/min. DEXA revealed 41.1 ± 8.3 % total fat with 41.2 ± 10.2 % in Arms, 39.0 ± 9.8 % Legs and 43.7 ± 10.3 % Trunk. Actigraph revealed 1.6 ± 0.3 MET rate, 13428.7 ± 4649.0 average steps/day and 58.1 ± 12.9 % in Sedentary, 26.3 ± 7.3 % in Light and 15.6 ± 6.2 % in moderate grade physical activity respectively . Viocare revealed 81.9% calories of Estimated Energy Requirement with 44.9 ± 7.1 % CHO, 36.7 ± 5.6 % total Fat, 13.5 ± 3.2 % saturated fat and 17.9 ± 3.1 % protein calories with Omega-3 and dietary fiber intake 0.1 ± 0.11 g and 23.1 ± 9.1 g respectively. On MTSOSD, at least one side effect (SE) was reported by every subject with range varying from 1 to 53 SE out of 59 in the questionnaire. Four (33%) subjects reported at least one grade 4 symptom (high distress); 1 reported grade 4 for 24 items out of 59 in questionnaire and the other 3 grade 4 for 1.7 ± 1.2 symptoms. For grade of symptoms ranging from 0 to 3, 30 ± 14 SE were reported by the 12 subjects. Conclusions: PT recipients that are insulin independent for long periods of time have suboptimal body composition and some immunosuppression related SE but perform better than average physical activity. Disclosure R. Kaur: None. C. Reid: None. S. Rizvi: None. S. Batthula: None. S.K. McCrady-Spitzer: None. B.H. Smith: None. W.K. Kremers: Research Support; Self; AstraZeneca. P. Dean: None. A. Kukla: None. M.D. Stegall: None. Y.C. Kudva: Research Support; Self; Dexcom, Inc., Roche Diabetes Care. Other Relationship; Self; Abbott.