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In addition to being a leading cost of kidney failure, diabetes causes a host of secondary hyperglycemic\u2010related complications including gastroparesis and orthostatic hypotension. While pancreas transplantation has been established as an effective treatment for diabetes, providing long\u2010term normoglycemia in recipients, the secondary complications of diabetes mellitus persist complicating the post\u2010operative course of an otherwise successful pancreas transplantation. This review describes the mechanism\u00a0and impact of diabetic gastroparesis and orthostatic hypotension in the post\u2010operative course of pancreas transplant patients and analyzes the various treatment modalities, based on current data and extensive experience at our institution, to treat these respective complications. While gastroparesis and orthostatic hypotension remain challenging post\u2010operative conditions, the establishment of institutional protocols and step\u2010up treatment algorithms can help define more effective therapies.<\/jats:p>","DOI":"10.1111\/ctr.14270","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T01:48:53Z","timestamp":1614563333000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Pancreas transplantation would be easy if the recipients were not diabetic: A practical guide to post\u2010operative management of diabetic complications in pancreas transplant recipients"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9605-2053","authenticated-orcid":false,"given":"Adam","family":"Cerise","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Abdominal Transplant Surgery Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne M.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Abdominal Transplant Surgery Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Powelson","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Abdominal Transplant Surgery Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Lutz","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Abdominal Transplant Surgery Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8708-1506","authenticated-orcid":false,"given":"Jonathan 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