Early Basal Insulin Therapy Decreases New-Onset Diabetes after Renal Transplantation (Articolo in rivista)

Type
Label
  • Early Basal Insulin Therapy Decreases New-Onset Diabetes after Renal Transplantation (Articolo in rivista) (literal)
Anno
  • 2012-01-01T00:00:00+01:00 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
  • 10.1681/ASN.2011080835 (literal)
Alternative label
  • Hecking, M.;Haidinger, M.;Doller, D.;Werzowa, J.;Tura, A.;Zhang, J.;Tekoglu, H.;Pleiner, J.;Wrba, T.;Rasoul-Rockenschaub, S.;Mu?lbacher, F.;Schmaldienst, S.;Druml, W.;Horl, W.H.;Krebs, M.;Wolzt, M.;Pacini, G.;Port, F.K.;Saëmann, M.D. (2012)
    Early Basal Insulin Therapy Decreases New-Onset Diabetes after Renal Transplantation
    in Journal of the American Society of Nephrology
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Hecking, M.;Haidinger, M.;Doller, D.;Werzowa, J.;Tura, A.;Zhang, J.;Tekoglu, H.;Pleiner, J.;Wrba, T.;Rasoul-Rockenschaub, S.;Mu?lbacher, F.;Schmaldienst, S.;Druml, W.;Horl, W.H.;Krebs, M.;Wolzt, M.;Pacini, G.;Port, F.K.;Saëmann, M.D. (literal)
Pagina inizio
  • 739 (literal)
Pagina fine
  • 749 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#url
  • http://www.ncbi.nlm.nih.gov/pubmed/22343119 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroVolume
  • 23 (literal)
Rivista
Note
  • Scopu (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#affiliazioni
  • Hecking, Haidinger, Doller, Werzowa, Schmaldienst, Druml, Horl, Saëmann: Department of Nephrology, Medical University of Vienna, Vienna, Austria / Tura, Pacini: Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy / Zhang, Port: Arbor Research Collaborative for Health, Ann Arbor, MI, United States / Tekoglu, Wrba: Department of Informatics, Medical University of Vienna, Vienna, Austria / Pleiner: Department of Coordinating Center for Clinical Studies, Medical University of Vienna, Vienna, Austria / Rasoul-Rockenschaub, Mu?lbacher: Department of Surgery, Medical University of Vienna, Vienna, Austria / Krebs: Department of Endocrinology, Medical University of Vienna, Vienna, Austria / Wolzt : Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria (literal)
Titolo
  • Early Basal Insulin Therapy Decreases New-Onset Diabetes after Renal Transplantation (literal)
Abstract
  • No effective interventions to reduce risk for new-onset diabetes after transplantation (NODAT), a condition associated with postoperative hyperglycemia and reduced patient and graft survival, have been established. In this 1-year, proof-of-concept clinical trial, we randomly assigned 50 renal transplant recipients to immediate-postoperative isophane insulin for evening blood glucose 0 mg/dl (treatment group) or short-acting insulin and/or oral antidiabetic agents for blood glucose 0-250 mg/dl (standard-of-care control group).We included only patients without a history of diabetes who received tacrolimus. By the third postoperative evening, all patients in the treatment group had blood glucose 0 mg/dl and were subsequently treated with basal insulin; during the first 3 weeks after transplantation, themean6SD daily insulin dosage was 17611 IU/d. Among controls, 23 (92%) of 25 had blood glucose 0 mg/dl and 18 (72%) of 25 received standard-of-care antihyperglycemic treatment. Asymptomatic hypoglycemia occurred five times in the treatment group and once in the control group. Throughout follow-up, the treatment group had 73% lower odds of NODAT (odds ratio, 0.27) than the control group, and hemoglobin A1c was on average 0.38% lower in the treatment group than the control group. Twelve months after transplantation, all patients in the treatment group were insulin-independent, whereas 7 (28%) of 25 controls required antidiabetic agents. The groups did not differ for insulin sensitivity, but the treatment group showed better b-cell function throughout the 1-year follow-up. In conclusion, this study suggests regimens that include basal insulin significantly reduce the odds for NODAT after renal transplantation, presumably via insulin-mediated protection of b cells. (literal)
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