title: Management of the hospitalized transplant patient.
abstract: Significant hyperglycemia is commonly observed immediately after solid organ and bone marrow transplant as well as with subsequent hospitalizations. Surgery and procedures are well known to cause pain and stress leading to secretion of cytokines and other hormones known to aggravate insulin action. Immunosuppression required for transplant and preexisting risk are also major factors. Glucose control improves outcomes for all hospitalized patients, including transplant patients, but is often more challenging to achieve because of frequent and sometimes unpredictable changes in immunosuppression doses, renal function, and nutrition. As a result, risk of hypoglycemia can be greater in this patient group when trying to achieve glucose control goals for hospitalized patients. Key to successful management of hyperglycemia is regular communication between the members of the care team as well as anticipating and rapidly implementing a new treatment paradigm in response to changes in immunosuppression, nutrition, renal function, or evidence of changing insulin resistance.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, UNMC and VA Nebraska-Western Iowa Health Care System, Omaha, NE, 68105, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Boerner
authors.forename: Vijay
authors.initials: V
authors.lastname: Shivaswamy
authors.forename: Whitney
authors.initials: W
authors.lastname: Goldner
authors.forename: Jennifer
authors.initials: J
authors.lastname: Larsen
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000209:etiology / Q000517:prevention & control; D006760:Hospitalization; D006801:Humans; D011182:Postoperative Care; D012307:Risk Factors; D014180:Transplantation / Q000009:adverse effects
chemical_list: D001786:Blood Glucose