2011 - IPITA - Prague
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Poster
1.152 - Effect of tacrolimus versus cyclosporine on glucose metabolism of pancreas and kidney recipients in the late posttransplant period
Presenter: T. , Havrdova1, ,
Authors: T. Havrdova1, F. Saudek1, T. Jedinakova1, K. Lipar2, J. Skibova3
P-152 Poster of distinction
Effect of tacrolimus versus cyclosporine on glucose metabolism of pancreas and kidney recipients in the late posttransplant period
T. Havrdova1, F. Saudek1, T. Jedinakova1, K. Lipar2, J. Skibova3
1 IKEM, Diabetes Center, Prague, Czech Republic; 2 IKEM, Transplant Center, Prague, Czech Republic; 3 IKEM, Statistical Department, Prague, Czech Republic
Background and Aims: The aim of our study was to compare the glucose metabolism in Type 1 diabetic recipients of kidney and pancreatic grafts on tacrolimus versus cyclosporine-based immunosuppression in conjunction with mycophenolate mofetil in the late posttransplant period.
Methods: We examined 20 insulin-independent patients after simultaneous pancreas and kidney transplantation with systemic venous drainage of pancreatic graft. All recipients had a stabile good function of the kidney graft. Fasting glycemia, insulin levels, glycosylated hemoglobin (HbA1c), a standard intravenous glucose tolerance test (IVGTT) with coefficient of glucose assimilation (KG) calculation and trough Tacro/Cyclo levels were assessed. Insulin sensitivity was evaluated using the homeostasis model assessment (HOMA-IR). Total C-peptide and insulin secretions were calculated as areas under the curves from the serum levels during the IVGTT.
Results: Tacro and Cyclo groups did not differ in age, BMI and posttransplant period (9.8±2.1 [SD] vs. 10.7±1.1 years). We did not find any significant difference in response of IVGTT. In Tacro group (n=10) 2 patients had an abnormal response to glucose stimulus, 3 patients had an impaired glucose tolerance and 5 patients had a normal glucose tolerance. In Cyclo group (n=10) the abnormal response was present in none, the impaired glucose tolerance in 3 and the normal glucose tolerance in 7 recipients. The other results are shown in the following table.
HbA1c DCCT (%) | Fasting glycemia (mmol/L) | HOMA-IR | KG (%/min.) | Total C-peptide secretion (pmol/mL) | Total insulin secretion (mIU/L) | |
Tacro group | 5.8 ± 0.42 | 5.1 ± 0.51 | 2.95 ± 2.86 | 1.27 ± 0.52 | 101 ± 49.5 | 1875 ± 1183 |
Cyclo group | 5.7 ± 0.27 | 4.9 ± 0.56 | 1.9 ± 1.66 | 1.6 ± 0.53 | 101 ± 50.1 | 1246 ± 993 |
Difference | NS | NS | NS | NS | NS | NS |
Trough levels of calcineurin inhibitors had no significant impact on any of examined parameters.
Conclusion: The use of different types of calcineurin inhibitors in Type 1 diabetic pancreas and kidney recipients had no effect on glucose metabolism in the late posttransplant period.
/P-152 Poster of distinction
Effect of tacrolimus versus cyclosporine on glucose metabolism of pancreas and kidney recipients in the late posttransplant period
T. Havrdova1, F. Saudek1, T. Jedinakova1, K. Lipar2, J. Skibova3
1 IKEM, Diabetes Center, Prague, Czech Republic; 2 IKEM, Transplant Center, Prague, Czech Republic; 3 IKEM, Statistical Department, Prague, Czech Republic
Background and Aims: The aim of our study was to compare the glucose metabolism in Type 1 diabetic recipients of kidney and pancreatic grafts on tacrolimus versus cyclosporine-based immunosuppression in conjunction with mycophenolate mofetil in the late posttransplant period.
Methods: We examined 20 insulin-independent patients after simultaneous pancreas and kidney transplantation with systemic venous drainage of pancreatic graft. All recipients had a stabile good function of the kidney graft. Fasting glycemia, insulin levels, glycosylated hemoglobin (HbA1c), a standard intravenous glucose tolerance test (IVGTT) with coefficient of glucose assimilation (KG) calculation and trough Tacro/Cyclo levels were assessed. Insulin sensitivity was evaluated using the homeostasis model assessment (HOMA-IR). Total C-peptide and insulin secretions were calculated as areas under the curves from the serum levels during the IVGTT.
Results: Tacro and Cyclo groups did not differ in age, BMI and posttransplant period (9.8±2.1 [SD] vs. 10.7±1.1 years). We did not find any significant difference in response of IVGTT. In Tacro group (n=10) 2 patients had an abnormal response to glucose stimulus, 3 patients had an impaired glucose tolerance and 5 patients had a normal glucose tolerance. In Cyclo group (n=10) the abnormal response was present in none, the impaired glucose tolerance in 3 and the normal glucose tolerance in 7 recipients. The other results are shown in the following table.
HbA1c DCCT (%) | Fasting glycemia (mmol/L) | HOMA-IR | KG (%/min.) | Total C-peptide secretion (pmol/mL) | Total insulin secretion (mIU/L) | |
Tacro group | 5.8 ± 0.42 | 5.1 ± 0.51 | 2.95 ± 2.86 | 1.27 ± 0.52 | 101 ± 49.5 | 1875 ± 1183 |
Cyclo group | 5.7 ± 0.27 | 4.9 ± 0.56 | 1.9 ± 1.66 | 1.6 ± 0.53 | 101 ± 50.1 | 1246 ± 993 |
Difference | NS | NS | NS | NS | NS | NS |
Trough levels of calcineurin inhibitors had no significant impact on any of examined parameters.
Conclusion: The use of different types of calcineurin inhibitors in Type 1 diabetic pancreas and kidney recipients had no effect on glucose metabolism in the late posttransplant period.
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