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J Endocrinol Invest ; 41(7): 821-829, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29289983

RESUMO

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.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus/tratamento farmacológico , Sobrevivência de Enxerto/efeitos dos fármacos , Insulina/administração & dosagem , Falência Hepática/cirurgia , Transplante de Fígado , Adulto , Idoso , Glicemia/metabolismo , Estudos Transversais , Complicações do Diabetes/sangue , Complicações do Diabetes/cirurgia , Diabetes Mellitus/sangue , Diabetes Mellitus/cirurgia , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Estudo Historicamente Controlado , Humanos , Falência Hepática/sangue , Falência Hepática/complicações , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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