Werzowa, Johannes M.Säemann, Marcus D.Mohl, AlexanderBergmann, MichaelKaltenecker, Christopher C.Brozek, WolfgangThomas, AndreasHaidinger, MichaelAntlanger, MarliesKovarik, Johannes J.Kopecky, ChantalSong, Peter X. K.Budde, KlemensPascual Santos, JulioHecking, Manfred2019-01-162019-01-162018Werzowa 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.01935691932-6203http://hdl.handle.net/10230/36281Treating 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.application/pdfengCopyright © 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.Ronyons -- Trasplantació -- Aspectes immunològicsInsulinainfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1371/journal.pone.0193569info:eu-repo/semantics/openAccess