Impact of kidney transplantation on glycemic control and cardiovascular risk factors in insulin-treated diabetic patients receiving cyclosporine: a longitudinal study.
BACKGROUND
In insulin-treated patients with diabetes, kidney transplantation (KTP) may influence glycemic control, insulin requirements, as well as vascular risk profiles, but the data are controversial. In 10 selected insulin-treated diabetic patients with normally functioning kidney transplants, receiving cyclosporine for immunosuppression, we evaluated the fasting blood glucose, HbA1c, lipid levels, blood pressure, and insulin-requirement from 1 year before to 1 year after KTP.


RESULTS
There were no significant differences in the mean HbA1c levels 6 and 3 months before transplantation (8.3 +/- 1.7 and 8.0 +/- 1.4%, respectively) and 3 and 12 months after transplantation (8.2 +/- 1.6 and 7.9 +/- 1.5%, respectively). The mean fasting blood glucose levels increased only transiently by 7% during the first week after transplantation (not significant). The insulin requirement was approximately the same at 3 and 6 months before (42 +/- 14 and 42 +/- 13 IU/d, respectively) and at 3 and 12 months after transplantation (44 +/- 13 and 41 +/- 13 IU/mL, respectively). Only 1 week after transplantation did the insulin requirement increase transiently by 14% to 48 +/- 14 IU/d (P < .05). The mean levels of cholesterol and triglycerides as well as mean blood pressure were not significantly different before and after transplantation.


CONCLUSIONS
Only immediately after KTP did mean blood glucose and insulin requirement increase. At least 3 months after transplantation, glycemic control and insulin requirements as well as the vascular risk factors were approximately the same as before the procedure.
Schmekal
B
B
2nd Department of Medicine, General Hospital, Linz, Austria.
Biesenbach
G
G
Janko
O
O
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016572:Cyclosporine; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors
D016572:Cyclosporine; D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids