A Ramos-Prol1,2,3, D Hervás-Marín4, B Rodríguez-Medina5, M Rubio-Almanza1,2, M Berenguer5, Á Moya-Herraiz5, J F Merino-Torres6,7. 1. Endocrinology and Nutrition Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain. 2. Unidad Mixta de Investigación de Endocrinología, Nutrición y Dietética, Instituto de Investigación Sanitaria La Fe (Health Research Institute La Fe), Valencia, Spain. 3. Department of Internal Medicine (Endocrinology and Nutrition), Hospital Francesc de Borja, Gandía, Spain. 4. Biostatistics Unit, Health Research Institute La Fe, Valencia, Spain. 5. Liver Transplantation and Hepatology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain. 6. Endocrinology and Nutrition Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain. merino_jfr@gva.es. 7. Unidad Mixta de Investigación de Endocrinología, Nutrición y Dietética, Instituto de Investigación Sanitaria La Fe (Health Research Institute La Fe), Valencia, Spain. merino_jfr@gva.es.
Abstract
PURPOSE: The debate about the impact of intensified hyperglycemia treatment is still ranging. The main objective was to assess whether intensive glycemic control in hospitalized diabetic patients undergoing a liver transplant is associated with a lower rate of graft rejection at 3 months and at 5 years post-transplant. METHODS: Cross-sectional study comparing a cohort of patients undergoing liver transplant in 2010 and 2011, in whom an intensive insulin protocol was applied, with a retrospective group of patients undergoing a liver transplant in 2005 and 2006, in whom a conventional insulin protocol was applied. Both diabetics and non-diabetics were compared. As intensive insulin therapy is applied mainly in diabetic patients, it is expected that, when comparing both periods, the treatment would only benefit those patients. RESULTS: The logistic regression model showed a statistically significant interaction between the treatment group and the presence of diabetes for the rejection rate 3 months and 5 years post-transplant. At both time points, the intensive insulin treatment group had lower rejection rates in the case of diabetic patients, which did not occur in non-diabetic patients. CONCLUSIONS: Our study shows a decrease in the rate of liver graft rejection in diabetic patients undergoing intensive insulin treatment.
PURPOSE: The debate about the impact of intensified hyperglycemia treatment is still ranging. The main objective was to assess whether intensive glycemic control in hospitalized diabeticpatients undergoing a liver transplant is associated with a lower rate of graft rejection at 3 months and at 5 years post-transplant. METHODS: Cross-sectional study comparing a cohort of patients undergoing liver transplant in 2010 and 2011, in whom an intensive insulin protocol was applied, with a retrospective group of patients undergoing a liver transplant in 2005 and 2006, in whom a conventional insulin protocol was applied. Both diabetics and non-diabetics were compared. As intensive insulin therapy is applied mainly in diabeticpatients, it is expected that, when comparing both periods, the treatment would only benefit those patients. RESULTS: The logistic regression model showed a statistically significant interaction between the treatment group and the presence of diabetes for the rejection rate 3 months and 5 years post-transplant. At both time points, the intensive insulin treatment group had lower rejection rates in the case of diabeticpatients, which did not occur in non-diabeticpatients. CONCLUSIONS: Our study shows a decrease in the rate of liver graft rejection in diabeticpatients undergoing intensive insulin treatment.
Authors: M Morigi; S Angioletti; B Imberti; R Donadelli; G Micheletti; M Figliuzzi; A Remuzzi; C Zoja; G Remuzzi Journal: J Clin Invest Date: 1998-05-01 Impact factor: 14.808
Authors: L Cacciatore; G Cozzolino; M G Giardina; F De Marco; L Sacca; P Esposito; G Francica; A Lonardo; M Matarazzo; A Varriale Journal: Diabetes Res Date: 1988-04