Classifying pancreas transplant patients as ‘mildly disabled’ ignores reality: diabetes union

The government has decided to officially recognize type 1 diabetes as a “pancreatic disorder” and add it to the list of internal disability types starting next May.

However, during the bill preparation process, patients who received pancreas transplants due to pancreatic disorders were classified as having “non-severe disabilities,” sparking controversy over reverse discrimination.

The Korean Diabetes Union (KDU) said on Monday that the Ministry of Health and Welfare's proposed “Pancreatic Disability Classification Criteria” ignores the suffering of pancreas transplant recipients and pushes patients facing greater hardship into a blind spot.

According to the KDU, the Ministry plans to classify patients who received pancreas transplants due to severe Type 1 diabetes as having a “non-severe disability” under the Pancreatic Disability Classification Criteria.

In a statement, the union highlighted the problems with the decision.

“Pancreas transplantation is not simply the result of undergoing surgery; it is a desperate treatment chosen as a last resort at the crossroads of life and death,” the statement said. “Despite this, categorizing transplant patients as having a ‘non-severe disability’ is a decision detached from the patients' reality.”

There are about 200 patients in Korea who have undergone a single pancreas transplant. Most of them suffer from type 1 diabetes and undergo the surgery after a difficult decision. They endure far more severe immune rejection reactions than kidney transplant recipients and must take immunosuppressants for life. Over time, many also require insulin injections again, meaning patients face the double burden of insulin plus immunosuppressants, according to the union.

Even if insulin is administered immediately after a failed pancreas transplant, the patient does not revert to a state of type 1 diabetes. Therefore, these patients are at high risk of being excluded from welfare support as they are classified as having a “non-severe disability,” it pointed out.

The union also argued that if pancreas transplant recipients are categorized as having a “non-severe disability,” patients who undergo simultaneous kidney and pancreas transplants face a significant risk of falling into a blind spot for welfare benefits and management.

According to the union, there are approximately 1,000 patients who have undergone simultaneous kidney and pancreas transplants. Undergoing simultaneous kidney and pancreas transplantation involves a surgical and treatment process of unimaginable difficulty. They endure each day amid concerns about immunosuppression and complications. Even if they resume insulin injections due to pancreas transplant failure, current regulations do not reclassify them as having a “severe disability.”

“Paradoxically, simply because they received a pancreas transplant, type 1 diabetes can be perceived as a disease that is less socially burdensome than Type 1 diabetes itself, despite its severity,” the union said. “Please properly acknowledge the real pain and difficulties experienced by the small number of pancreas transplant patients.”