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Youngest pancreas transplantation alone in the UK for type 1 diabetes and severe subcutaneous insulin resistance
  1. Garm Chi Ho1,
  2. Sajanee Liz Samuel2,
  3. Usman Haroon1 and
  4. Martin Drage1
  1. 1 Department of Nephrology and Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, UK
  2. 2 Department of Paediatrics, Princess Alexandra Hospital NHS Foundation Trust, Harlow, UK
  1. Correspondence to Garm Chi Ho; justinhogc{at}


A child diagnosed with type 1 diabetes mellitus during her middle childhood developed severe subcutaneous insulin resistance as her illness progressed. This resulted in recurrent episodes of diabetic ketoacidosis and hypoglycaemia, eventually leading to intravenous insulin dependence. Despite intensive investigations, an organic cause was not found.

The patient was in her late adolescence when she eventually received her pancreas transplant alone, the youngest patient in the UK. This case highlights severe peripheral insulin resistance as an important indication for whole organ pancreas transplantation in the paediatric population, as well as early recognition in the failure of conventional medical therapy.

  • Endocrine system
  • Transplantation
  • Paediatrics
  • Diabetes

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  • Contributors All named authors contributed significantly to this report in various aspects. GCH is the main contributor to the writing of the manuscript, data collection, literature review, obtaining patient consent and submission of the report. SLS contributed to drafting of the manuscript and literature review. UH and MD both supervised the entire process of writing and submission of the report. All authors read and agreed to the published version of the manuscript. GCH, SLS, UH and MD gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.