Apple Cider Vinegar Before Meals Lowers Blood Sugar

Answer by Dr. Albana Greca, MD, MMedSc

Hi Anne,

It is encouraging that your friend is doing well. For someone whose type 1 diabetes is safely controlled with insulin, CGM, and modern diabetes technology, transplant risks usually outweigh the possible benefit.

What Does a Pancreas Transplant Do?

A donated pancreas contains beta cells that can produce insulin. When the graft works, glucose may return to near-normal levels and insulin injections may no longer be required. The recipient still needs lifelong transplant follow-up and anti-rejection treatment.

A transplant does not erase the history of type 1 diabetes. The graft can be rejected, autoimmune damage may recur, or the pancreas may eventually fail. Insulin may therefore be needed again.

Who May Be Considered?

• Simultaneous pancreas-kidney transplant: for selected people with type 1 diabetes and kidney failure.


• Pancreas after kidney transplant: when a kidney transplant has already been completed.


• Pancreas transplant alone: rarely, for recurrent severe hypoglycemia, ketoacidosis, or disabling instability despite optimized treatment.

A specialist team first reviews diabetes education, insulin delivery, CGM, automated insulin delivery, and prevention of severe lows. Our type 1 diabetes guide explains current daily care.

Whole Pancreas Versus Islet Transplantation

A whole-pancreas transplant is major abdominal surgery. Islet transplantation is different: insulin-producing islets from a deceased donor are infused into the portal vein and settle in the liver. It is not a partial-pancreas operation.

In the United States, the donor-islet product Lantidra is approved only for selected adults unable to approach their HbA1c goal because of repeated severe hypoglycemia despite intensive management and education. Some recipients stop insulin, while others still need it or lose graft function later.

How Long Can Insulin Independence Last?

There is no guaranteed duration. A functioning pancreas graft may provide insulin independence for many years, but outcomes differ by procedure, rejection, infection, blood-vessel complications, and adherence to immunosuppressive medicine.

Donor-islet results also vary. Some recipients remain insulin-independent for years; others need reduced insulin, require another infusion, or never stop insulin. Preventing severe hypoglycemia may be the main goal.

What Are the Main Risks?

• Bleeding, blood clots, infection, pancreatitis, or other surgical complications


• Rejection or loss of graft function


• Kidney injury, high blood pressure, or other medicine effects


• Higher risks of serious infection and certain cancers from immunosuppression

The old claim that one or two of every ten recipients die is not an appropriate universal estimate. Risk varies by health, procedure, center, kidney disease, and cardiovascular status. A transplant team must assess the individual balance of benefit and harm.

Does Transplantation Stop Complications?

Successful transplantation can normalize glucose and may prevent, slow, or sometimes improve certain complications. It does not guarantee that established kidney, eye, nerve, or cardiovascular damage will disappear. It is not a routine treatment for neuropathy alone.

Screening remains important after transplantation. Read more about diabetes complications and prevention.

What Is Happening With Stem Cells?

Stem-cell-derived islet therapy is promising. Scientists can now produce insulin-secreting islet cells from stem cells and transplant them into selected participants.

In an early zimislecel study, most full-dose participants produced insulin and became insulin-independent at one year. However, the study was small, recipients required immunosuppression, serious adverse events occurred, and long-term durability remains unknown. The treatment is in phase 3 research but is not an approved routine stem-cell cure.

Encapsulated and gene-edited cells that might avoid lifelong immunosuppression are also being studied. These approaches remain experimental. Avoid clinics selling unapproved stem-cell “cures,” which may be ineffective or dangerous.

What Should Your Friend Do?

If she is doing well without severe hypoglycemia or kidney failure, she should continue specialist care rather than pursue transplantation solely to avoid insulin. Modern insulin treatment, CGM, pumps, and automated insulin delivery can improve safety without transplant risks.

If she has recurrent severe lows, impaired awareness of hypoglycemia, repeated ketoacidosis, or advanced kidney disease, her endocrinologist can refer her to an accredited transplant center.

Related Questions

• Can pancreatic beta cells regenerate in type 1 diabetes?


• What complications may occur with type 1 diabetes?


• What are the benefits and risks of an insulin pump?

Related Resources

• Type 1 diabetes information and management


• Insulin types, pumps, dosing, and safety


• Diabetes, kidney disease, and screening

Last reviewed: July 2026.