Pancreas transplantation and reversal of diabetic nephropathy lesions.

Pancreas transplantation is the only available treatment that has restored long-term (10 or more years) normoglycemia without the risks of severe hypoglycemia, allowing testing of the reversibility of diabetic nephropathy lesions. The authors studied renal structure before and 5 and 10 years after pancreas transplantation in nonuremic patients with long-term type 1 diabetes, with established diabetic nephropathy lesions at baseline. Diabetic glomerular lesions were not significantly changed at 5 years but were dramatically improved after 10 years, with most patients' glomerular structure returning to normal at the 10-year follow-up. These studies also showed that tubulointerstitial remodeling was also possible.