Hyperglycemia during the immediate period following liver transplantation. (March 2016)

• Record Type: Journal Article
• Authors: Werner, K Tuesday; Mackey, Patricia A; Castro, Janna C; Carey, Elizabeth J; Chakkera, Harini A; Cook, Curtiss B
• Is Part Of: Future science OA. Volume 2:Number 1(2016)
• Publication Date: 2016-03
• Subjects: diabetes mellitus -- hospital -- hyperglycemia -- inpatient -- liver transplant; Medicine -- Periodicals; Biotechnology -- Periodicals; 610
• DOI: 10.4155/fsoa-2015-0010
• Languages: English
• ISSNs: 2056-5623

Abstract

Aim: High blood glucose levels in the hospital are common among transplant recipients.Methods: Retrospective analysis, stratified by diagnosis of pretransplant diabetes mellitus (DM).Results: Of 346 patients, 96 had pretransplant DM (insulin, n = 60; no insulin, n = 36) and 250 did not. Patients with pretransplant DM had higher inpatient mean glucose levels and more hyperglycemia and hypoglycemia (all p < 0.01). For patients without pretransplant DM, the need for insulin at discharge increased 23% for every 5-year age increase (odds ratio: 1.23; 95% CI: 1.06–1.44; p = 0.007) and 51% for every five units of glucose measurements >180 mg/dl (OR: 1.51; 95% CI: 1.23–1.95; p < 0.01).Conclusion: Inpatient hyperglycemia was common in liver transplant recipients. Hospital practitioners must anticipate the need to teach self-management skills to liver transplant recipients. Lay abstract: High blood glucose levels (also known as hyperglycemia) in the hospital are common among patients who have received a transplant. The authors conducted a study to determine how often high blood glucose values occurred in patients who received a liver transplant and found that values were highest in people who had diabetes before the transplant. However, even patients who did not have a history of diabetes had hyperglycemia and needed insulin treatment. Providers caring for these patients in the hospital must be prepared to provide education in diabetes self-management skills to virtually all patients undergoing a liver transplant.