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Rosiglitazone treatment of diabetes mellitus after solid organ transplantation

David Baldwin1, Karen E Duffin

  • 1Section of Endocrinology, Rush Presbyterian St Luke's Medical Center, Chicago, IL 60612, USA. david_baldwin@rush.edu

Transplantation
|April 17, 2004
PubMed
Abstract

Insights

Rosiglitazone effectively managed type 2 diabetes in transplant patients, improving HbA1C levels. This oral medication offered a safe alternative to insulin for those with posttransplant diabetes.

Area of Science:

  • Nephrology
  • Endocrinology
  • Transplantation Medicine

Background:

  • Diabetes mellitus is a prevalent complication following solid organ transplantation.
  • Both pre-existing and post-transplant diabetes often necessitate insulin therapy.
  • Effective glycemic control is crucial for mitigating cardiovascular disease risk in transplant recipients.

Purpose of the Study:

  • To evaluate the safety and efficacy of rosiglitazone in managing type 2 diabetes in post-solid organ transplant patients.
  • To assess rosiglitazone's impact on glycemic control (HbA1C) and its interaction with immunosuppressive medications.
  • To determine if rosiglitazone could serve as an oral alternative to insulin therapy for post-transplant diabetes.

Main Methods:

  • A cohort of 18 patients with type 2 diabetes post-transplantation received rosiglitazone.
  • Rosiglitazone was administered alongside insulin or glyburide for pre-existing diabetes, or as a standalone therapy for post-transplant diabetes.
  • Key parameters monitored included HbA1C, serum creatinine, cyclosporine, and tacrolimus levels over a mean follow-up of 381 days.

Main Results:

  • Rosiglitazone treatment led to a significant improvement in mean HbA1C levels from 8.1% to 6.9% (P=0.01).
  • Patients with post-transplant diabetes showed significant HbA1C reduction from 8.6% to 6.7% (P=0.035), with all achieving control without insulin.
  • No significant adverse effects on serum creatinine, cyclosporine, or tacrolimus levels were observed, nor were there changes in immunosuppressant doses.

Conclusions:

  • Rosiglitazone is a safe and effective oral therapeutic agent for managing diabetes mellitus in solid organ transplant recipients.
  • It represents a novel option for oral therapy in patients with post-transplant diabetes.
  • Rosiglitazone provides a well-tolerated alternative to insulin for managing diabetes after transplantation.

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