2.1 | Case

The patient was a 46‐year‐old male who was diagnosed with type 1 diabetes at 8 years of age. The patient was 164.0 cm tall and weighed 44.0 kg. Recent HbA1c levels were 8.0%–11.0% (64–97 mmol/mol). He required daily insulin injections to manage severe hyperglycemia. He underwent surgery for vitreal hemorrhage at 39 and 40 years. At 43 years, hemodialysis was started for managing end‐stage renal failure caused by diabetic nephropathy. Despite using intermittent‐scanned continuous glucose monitoring, the serum glucose levels remained uncontrolled. After glucagon stimulation testing, urine and serum C‐peptide levels were >0.5 μg/day (0.166 nmol/day) and >0.05 ng/mL (16.6 pmol/L), respectively. Therefore, simultaneous pancreas–kidney transplantation (SPK) was performed at 46 years using donor organs after brain death (Data S1).