This study proposes a simple and safe way of lowering this complicate rate, while improving graft recovering and protecting the graft as it recovers from the transplant. The investigators hypothesize that by maintaining a tight glucose control via a glucose-insulin clamp during surgery and 72 hours post-operatively the investigators will be able to lower the complication rate by 50%.

Inclusion Criteria:

• Male or female patient over 18 years of age
• Patient is about to receive a pancreas or a simultaneous pancreas/kidney transplant
• Able to give written informed consent prior to any study specific procedure

Exclusion Criteria:

• Multi-organ transplant other than kidney transplant
• No central venous access available to deliver the D20W solution