SPK (simultaneous pancreas-kidney transplant) is an established\u00a0<\/span>option<\/span>\u00a0for selected patients with T1DM and ESKD. We report a 34-year-old woman with long-standing T1DM, hypertension,\u00a0<\/span>dyslipidaemia<\/span>\u00a0and hypothyroidism, complicated by diabetic nephropathy progressing to ESKD, on twice-weekly\u00a0<\/span>haemodialysis<\/span>\u00a0for 2 years.\u00a0<\/span>Glycaemic<\/span>\u00a0and blood pressure control remained poor despite maximal medical therapy. She was evaluated for kidney transplantation with consideration of SPK due to insulin dependence and metabolic instability. Multidisciplinary assessment guided transplant strategy in this high-risk young patient.<\/span><\/span><\/p>\n This case illustrates the complex decision-making involved in transplant planning for young patients with long-standing type 1 diabetes mellitus complicated by end-stage kidney disease and multiple metabolic comorbidities. It highlights the clinical importance of considering simultaneous pancreas-kidney transplantation (SPK) in selected patients with insulin-dependent diabetes and poor\u00a0<\/span>glycaemic<\/span>\u00a0control despite\u00a0<\/span>optimal<\/span>\u00a0medical therapy. The case underscores the need for early referral and comprehensive multidisciplinary assessment to balance perioperative risk against long-term metabolic and renal benefits. Careful patient selection\u00a0<\/span>remains<\/span>\u00a0critical to\u00a0<\/span>optimizing<\/span>\u00a0outcomes and improving quality of life in this high-risk population.<\/span><\/span>\u00a0<\/span><\/p>\n<\/div>\n<\/h4>\n
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