A randomized controlled trial-based algorithm for insulin-pump therapy in hyperglycemic patients early after kidney transplantation
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- dc.contributor.author Werzowa, Johannes M.
- dc.contributor.author Säemann, Marcus D.
- dc.contributor.author Mohl, Alexander
- dc.contributor.author Bergmann, Michael
- dc.contributor.author Kaltenecker, Christopher C.
- dc.contributor.author Brozek, Wolfgang
- dc.contributor.author Thomas, Andreas
- dc.contributor.author Haidinger, Michael
- dc.contributor.author Antlanger, Marlies
- dc.contributor.author Kovarik, Johannes J.
- dc.contributor.author Kopecky, Chantal
- dc.contributor.author Song, Peter X. K.
- dc.contributor.author Budde, Klemens
- dc.contributor.author Pascual Santos, Julio
- dc.contributor.author Hecking, Manfred
- dc.date.accessioned 2019-01-16T08:09:54Z
- dc.date.available 2019-01-16T08:09:54Z
- dc.date.issued 2018
- dc.description.abstract Treating hyperglycemia in previously non-diabetic individuals with exogenous insulin immediately after kidney transplantation reduced the odds of developing Posttransplantation Diabetes Mellitus (PTDM) in our previous proof-of-concept clinical trial. We hypothesized that insulin-pump therapy with maximal insulin dosage during the afternoon would improve glycemic control compared to basal insulin and standard-of-care. In a multi-center, randomized, controlled trial testing insulin isophane for PTDM prevention, we added a third study arm applying continuous subcutaneous insulin lispro infusion (CSII) treatment. CSII was initiated in 24 patients aged 55±12 years, without diabetes history, receiving tacrolimus. The mean daily insulin lispro dose was 9.2±5.2 IU. 2.3±1.1% of the total insulin dose were administered between 00:00 and 6:00, 19.5±11.6% between 6:00 and 12:00, 62.3±15.6% between 12:00 and 18:00 and 15.9±9.1% between 18:00 and 24:00. Additional bolus injections were necessary in five patients. Mild hypoglycemia (52-60 mg/dL) occurred in two patients. During the first post-operative week glucose control in CSII patients was overall superior compared to standard-of-care as well as once-daily insulin isophane for fasting and post-supper glucose. We present an algorithm for CSII treatment in kidney transplant recipients, demonstrating similar safety and superior short-term efficacy compared to standard-of-care and once-daily insulin isophane.
- dc.format.mimetype application/pdf
- dc.identifier.citation Werzowa JM, Säemann MD, Mohl A, Bergmann M, Kaltenecker CC, Brozek W. et al. A randomized controlled trial-based algorithm for insulin-pump therapy in hyperglycemic patients early after kidney transplantation. PLoS One. 2018 Mar 8;13(3):e0193569. DOI: 10.1371/journal.pone.0193569
- dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0193569
- dc.identifier.issn 1932-6203
- dc.identifier.uri http://hdl.handle.net/10230/36281
- dc.language.iso eng
- dc.publisher Public Library of Science (PLoS)
- dc.relation.ispartof PLoS One. 2018 Mar 8;13(3):e0193569
- dc.rights Copyright © 2018 Werzowa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri https://creativecommons.org/licenses/by/4.0/
- dc.subject.other Ronyons -- Trasplantació -- Aspectes immunològics
- dc.subject.other Insulina
- dc.title A randomized controlled trial-based algorithm for insulin-pump therapy in hyperglycemic patients early after kidney transplantation
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion