COMPLICATIONS - METABOLIC

Y. An¹, G. Chen², C. Cai², T. Zhang^2
1Department Of Transplant Center, the Third Affiliated Hospital of Sun Yat - sen Universtity,, Guangzhou 510630,China/CHINA, ²Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou/CHINA

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Introduction.New-onset diabetes mellitus are frequently observed in patients having undergone liver transplantation (LTx). Management of new-onset diabetes after transplantation generally conforms to the guidelines for treatment of type 2 diabetes mellitus in the general population. Combinations of insulin and oral antidiabetic drugs are often prescribed instead of insulin alone .This randomized, comparative study assessed the safety and efficacy of the insulin glargine combined with the oral antidiabetic drug acarbose in the treatment of new-onset diabetes mellitus following LTx . Methods: Totally 60 patients of diabetes mellitus following orthotopic liver transplantation with fasting blood glucose (FBG) levels >or= 7.0 mmol/l [corrected] and hemoglobin glycated (A1C) >or=7% were enrolled. They were randomly divided into two groups. Patients of group 1 were injected with insulin glargine ( at 22 PM every day, n = 32) in addition to taking acarbose three times daily with meals and patients of group 2 were injected with premix insulin ( novolin 30R 30 min before breakfast and supper, n = 28) .The levels of premeal and postprandial blood glucose were examined. The effect of blood glucose control and the incidence of hypoglycemia were observed. Results: After treatment for 3 months, 26 patients in group A and 24 patients in group B completed the study . A1C levels were significantly decreased from 8.21±0.87% to 7.18±0.48% in group 1 and 8.35±0.89% to 7.28±0.48% in group 2 .FBG levels were significantly decreased from 8.27±1.09 to 6.56±0.57 mmol/l in group 1 and 8.15±1.03 to 6.54±0.56 mmol/l in group 2. Postprandial glucose levels were significantly decreased from 13.91±1.40 to 9.70±1.13 mmol/l in group 1 and 14.59±1.30 to 9.78±0.99 mmol/l in group 2. No obvious weight gain was detected in both of groups, compared to the baseline.The dose of insulin in group 1 was lower than in group 2 (21.0±5.3IU vs 26.3±5.5IU; P = 0.03) and incidence of hypoglycemia were significantly lower in group 1 (7.69ï¼…vs 33.3%%; P = 0.02) .The difference in rate of acute rejection and other side effects such as infection , hypertension and hyperlipemia were not statistically significant between the two groups( P > 0. 05).Conclusion: Insulin glargine combined with acarbose is an effective, safe and digestible treatment for the patients of diabetes mellitus following orthotopic liver transplantation.

Disclosure: All authors have declared no conflicts of interest.