Abstract | BACKGROUND: METHODS: We, therefore, decided to use an intravenous glucose tolerance test (IV-GTT), to investigate whether conversion from cyclosporine-based immunosuppression, with a median trough level of 120 microg/l, to tacrolimus-based immunosuppression with a median trough level of 6.5 microg/l influences glucose metabolism and whether patients on steroids behave differently from those not on steroids. RESULTS: Thirty stable, non-diabetic patients, transplanted 10 or more years earlier, were converted from cyclosporine to tacrolimus without changing their concomitant medication. IV-GTT's were performed before and 2.5 months after the conversion. Before conversion, 40% of the patients had an abnormal glucose disappearance rate (kG): in 7%, kG was below 0.8 (abnormal range) and in 34%, kG was between 0.8 and 1.2 (indeterminate range). After conversion, stimulated insulin production, kG, HbA1C and fasting glucose did not change significantly. Insulin resistance (HOMA-R) of the whole group increased significantly, mainly due to a rise in HOMA-R in patients on steroids (n = 18). None of these patients developed overt diabetes mellitus. CONCLUSIONS:
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Authors | Marielle A C J Gelens, Maarten H L Christiaans, Johannes P van Hooff |
Journal | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
(Nephrol Dial Transplant)
Vol. 23
Issue 2
Pg. 701-6
(Feb 2008)
ISSN: 1460-2385 [Electronic] England |
PMID | 17999993
(Publication Type: Journal Article)
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Chemical References |
- Emulsions
- Immunosuppressive Agents
- Cyclosporine
- Glucose
- Tacrolimus
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Topics |
- Adult
- Aged
- Cross-Over Studies
- Cyclosporine
(administration & dosage)
- Emulsions
- Female
- Glucose
(metabolism)
- Humans
- Immunosuppressive Agents
(administration & dosage)
- Kidney Transplantation
- Male
- Middle Aged
- Tacrolimus
(administration & dosage)
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