Clinical Profile of Patients With Diabetes Mellitus and Liver Transplantation: Results After a Multidisciplinary Team Intervention.

Autor: Moura Neto A; Discipline of Endocrinology, Internal Medicine Department, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil. Electronic address: arnaldo.mouraneto@gmail.com., Bovi TG; Discipline of Endocrinology, Internal Medicine Department, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil., Righetto CM; Discipline of Endocrinology, Internal Medicine Department, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil., Fiore AR; Discipline of Endocrinology, Internal Medicine Department, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil., Lot LT; Surgery Department, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil., Perales SR; Surgery Department, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil., de Ataide EC; Surgery Department, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil., Boin IFSF; Surgery Department, Faculty of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2018 Apr; Vol. 50 (3), pp. 784-787.
DOI: 10.1016/j.transproceed.2018.02.042
Abstrakt: Background: Over the years, survival after liver transplantation has increased and metabolic complications are becoming more common, contributing to patients' morbidity and mortality. The objectives of this study were to describe a population of patients with hepatic transplantation and diabetes mellitus (DM), evaluate the frequency of metabolic complications, and assess the impact of a multidisciplinary team on DM management.
Materials and Methods: This was a retrospective study involving interview and medical record analysis of 46 consecutive patients followed at the diabetes mellitus and liver transplantation unit of a tertiary university hospital, all evaluated by a multidisciplinary team.
Results: Of all patients, 76.1% were men, with a median age 60 years old (interquartile range: 56 to 65 years) and liver transplantation time of 5 years (interquartile range: 0.6-9 years). Hypertension, hypercholesterolemia, hypertriglyceridemia, alcoholism, and smoking were present in 47.8%, 34.8%, 23.9%, 34.8%, and 30.4% of the patients, respectively. The most frequent immunosuppressant in use was tacrolimus (71.1%). Regarding nutritional status, 37.9% of patients were classified as overweight according to body mass index, and 41.2% were considered overweight according to the triceps skin fold. The median glycosylated hemoglobin and weight before and after intervention of the multidisciplinary team in all 46 patients were, respectively, 7.6% (5.7% to 8.8%) versus 6.5% (5.7% to 7.7%); P = .022 and 70.5 kg (64.7 to 82.0 kg) versus 71.6 kg (65.0 to 85.0 kg); P = .18.
Conclusions: Hypertension and dyslipidemia were common in transplanted patients with DM. Intervention of the multidisciplinary team resulted in a significant improvement in glycosylated hemoglobin without significant weight gain.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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