Pancreas and islet cell transplantation is considered in patients with chronic diabetes who have frequent metabolic complications and are intolerant to exogenous insulin or have failed insulin therapy.

• There is no indication for surgery in type 2 diabetes mellitus unless, there is an indication for pancreas and islet cell transplantation. Pancreas transplantation is considered for patients with chronic diabetes and multiple complications.
• Pancreas and islet cell transplantation have been shown to normalize glucose levels but require lifelong immunosuppression to prevent graft rejection and recurrence of autoimmune islet destruction.
• Islet cell transplantation remains investigational.
• Indication for pancreas transplantation is:^[1]
  • Patients who have history of frequent severe metabolic derangement (hypoglycemia, marked hyperglycemia, ketoacidosis),
  • Intolerant to exogenous insulin therapy
  • Failure of treatment with insulin.