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J Endocrinol Invest ; 41(7): 821-829, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29289983

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.


Subject(s)
Blood Glucose/drug effects , Diabetes Mellitus/drug therapy , Graft Survival/drug effects , Insulin/administration & dosage , Liver Failure/surgery , Liver Transplantation , Adult , Aged , Blood Glucose/metabolism , Cross-Sectional Studies , Diabetes Complications/blood , Diabetes Complications/surgery , Diabetes Mellitus/blood , Diabetes Mellitus/surgery , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Historically Controlled Study , Humans , Liver Failure/blood , Liver Failure/complications , Male , Middle Aged , Retrospective Studies
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