Thiazolidinedione therapy in a patient with diabetes after cardiac transplantation.
OBJECTIVE
To describe the successful use of a thiazolidinedione agent for the treatment of diabetes diagnosed after heart transplantation.


METHODS
We present a case report of a 51-year-old woman who underwent cardiac transplantation because of cardiomyopathy; diabetes developed 6 months later. Her clinical course and serial laboratory findings are documented as insulin therapy was initiated and subsequently transitioned to rosiglitazone during maintenance of the immunosuppressive regimen.


RESULTS
After rosiglitazone therapy was instituted, the patient's insulin dose was gradually tapered and eventually stopped. Target glycemic control was maintained without apparent aggravation of cardiac function or volume overload. No deleterious effects on other organ systems or interactions with the antirejection medications were noted during close follow-up.


CONCLUSIONS
Rosiglitazone may be safe and effective therapy for patients with posttransplantation diabetes. Rosiglitazone also helps to counteract the insulin-resistant state and reduces or eliminates the need for exogenous insulin. Further studies should attempt to confirm the usefulness of treatment with thiazolidinediones for patients with diabetes after organ transplantation.
Rizvi
Ali A
AA
Internal Medicine and Endocrine Associates of Augusta and the Medical College of Georgia, Augusta, Georgia 30901, USA.
Bowman
Mac A
MA
D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D013844:Thiazoles / Q000627:therapeutic use*; D045162:Thiazolidinediones
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D007328:Insulin; D013844:Thiazoles; D045162:Thiazolidinediones; C089946:2,4-thiazolidinedione