This study investigates the effects of pancreas transplantation on diabetic nephropathy in patients with type 1 diabetes who do not have uremia and have not received a kidney transplant. The research focuses on kidney function and renal biopsies performed before, 5 years, and 10 years after pancreas transplantation in eight patients. Key findings include: - All patients maintained normal glycosylated hemoglobin values post-transplantation. - Urinary albumin excretion rates decreased over time, from 103 mg/day before transplantation to 20 mg/day 10 years later. - Creatinine clearance rates declined significantly within 5 years but remained stable thereafter. - Glomerular and tubular basement membrane thickness decreased by 10 years, indicating reversal of diabetic nephropathy. - Mesangial fractional volume increased initially but decreased by 10 years, suggesting resolution of mesangial expansion. The study concludes that pancreas transplantation can reverse diabetic nephropathy, but this reversal requires more than five years of normoglycemia. The findings highlight the importance of long-term normoglycemia in managing and potentially reversing diabetic kidney disease.This study investigates the effects of pancreas transplantation on diabetic nephropathy in patients with type 1 diabetes who do not have uremia and have not received a kidney transplant. The research focuses on kidney function and renal biopsies performed before, 5 years, and 10 years after pancreas transplantation in eight patients. Key findings include: - All patients maintained normal glycosylated hemoglobin values post-transplantation. - Urinary albumin excretion rates decreased over time, from 103 mg/day before transplantation to 20 mg/day 10 years later. - Creatinine clearance rates declined significantly within 5 years but remained stable thereafter. - Glomerular and tubular basement membrane thickness decreased by 10 years, indicating reversal of diabetic nephropathy. - Mesangial fractional volume increased initially but decreased by 10 years, suggesting resolution of mesangial expansion. The study concludes that pancreas transplantation can reverse diabetic nephropathy, but this reversal requires more than five years of normoglycemia. The findings highlight the importance of long-term normoglycemia in managing and potentially reversing diabetic kidney disease.