Comparison of Intensive Insulin Versus Oral Regimens on Early Glycemic Control Following Kidney Transplant.
Prog Transplant
; 32(4): 327-331, 2022 12.
Article
em En
| MEDLINE
| ID: mdl-36114645
ABSTRACT
Introduction:
Insulin is commonly prescribed to manage early post-kidney transplant hyperglycemia due to its flexibility. Studies comparing the effectiveness of oral therapies on glycemic outcomes remain limited. Projectaims:
The purpose of this program evaluation was to analyze our experience using oral antiglycemic agents immediately post-kidney transplant, compared to patients managed with insulin monotherapy.Design:
This was a single-center, retrospective review of adult kidney transplant recipients with new or worsening hyperglycemia between 01/2014-05/2020. Patients were excluded if they had a prior or combined organ transplant, type 1 diabetes, or were previously on intensive insulin. Patients discharged on oral medications were 11 matched to patients receiving intensive insulin based on pre-specified clinical parameters. The primary endpoint was the number of diabetes-related readmissions within 6-months of transplant. Key secondary endpoints included mean serum glucose and hemoglobin A1c levels.Results:
Thirty patients prescribed oral therapies were successfully matched to patients receiving intensive insulin. Baseline characteristics were similar between groups, except for more whites in the insulin group. There were no differences in diabetes-related (6.7% vs 3.3%; P = 1.00) or all-cause readmissions within 6-months. Mean serum glucose (P = .99) and hemoglobin A1c (P = .49) levels were also similar between patients receiving oral agents and insulin. However, 7 patients in the oral group were eventually converted to standing insulin.Conclusion:
Our experience suggested that the early use of oral antiglycemics post-kidney transplant in select patients can result in similar outcomes relative to insulin. Meticulous follow-up is necessary as one-quarter of patients may require conversion to insulin within 1-month.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Rim
/
Diabetes Mellitus Tipo 2
/
Hiperglicemia
Tipo de estudo:
Etiology_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Prog Transplant
Assunto da revista:
ENFERMAGEM
/
TRANSPLANTE
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos