Liver transplantation eliminates insulin needs of a diabetic patient.
Organ transplantation and subsequent therapeutic agents may induce or worsen preexisting diabetes mellitus. We report the case of a diabetic patient whose insulin needs disappeared after liver transplantation. Non insulin-dependent diabetes mellitus was diagnosed when she was 47, and was treated by hypoglycemic drugs and then insulin. Chronic post-hepatitis C cirrhosis was diagnosed at the age of 55 and required liver transplantation 2 years later. During the postoperative course, the insulin doses required to maintain normal glucose levels progressively decreased, and insulin became completely unnecessary by the 29(th) postoperative day. After insulin was stopped, glucose levels remained within normal ranges for the 5-year-long follow-up, despite the worsening of a preexisting diabetic nephropathy and the occurrence of a diabetic retinopathy. This case highlights the fact that liver transplantation may eliminate insulin needs in a diabetic patient but also shows that degenerative complications may occur despite apparent remission of diabetes.
Vlaeminck-Guillem
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V
Clinique Endocrinologique Marc Linquette, USN A, CHRU de Lille, 59037 Lille Cedex.
Guillem
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P
Dequiedt
P
P
Pruvot
F R
FR
Fontaine
P
P
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D016572:Cyclosporine / Q000009:adverse effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000503:physiopathology; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007328:Insulin / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000209:etiology; D016031:Liver Transplantation / Q000502:physiology*; D008875:Middle Aged; D011184:Postoperative Period
D001786:Blood Glucose; D007166:Immunosuppressive Agents; D007328:Insulin; D016572:Cyclosporine