Prevalence of 'low blood glucose' symptoms and quality of life in pancreas transplant recipients

One hundred and twenty-nine Type I diabetic pancreas transplant recipients who were at least 1 year post-transplant (n= 62 functioning graft, n=67 non-functioning graft) completed a quality of life questionnaire that included self-report ratings of symptoms. Reports of frequent low blood glucose symptoms, distress due to low blood glucose symptoms, and subjective ratings of poorer blood glucose control were significantly and highly correlated with dissatisfaction ratings on diabetes-specific measures of satisfaction with lifestyle, health and treatment r= 0.43 to 0.67, p<0.01). Overall life satisfaction and physical functioning were also significantly correlated with these symptom perceptions (r= 0.23 to 0.43, p<0.01). Symptoms had a significant impact on quality of life measures even after adjustment for the effects of pancreas graft status and other case-mix factors. The prevalence of reported low blood glucose symptoms in the previous month was about one-third for patients with a functioning pancreas graft (n= 19) compared to almost all patients in the non-functioning group (31% vs. 97%, p<0.0001). A limitation of this study is the absence of documented blood glucose values to correlate with symptom perceptions. Perceived low blood glucose symptoms could be inaccurate, particularly for very mild symptoms, and correlation with actual blood glucose may be very low. The symptomatic patients with functioning grafts generally reported a few mild symptoms per month, and this study was not able to demonstrate that symptomatic patients with functioning grafts have reduced quality of life. Thus, while the prevalence of transient self-reported symptoms of hypoglycemia in successful pancreas transplant recipients is 31% in this series, the severity of their symptoms is insufficient to impact quality of life measures.