Repaglinide in the Management of New‐Onset Diabetes Mellitus After Renal Transplantation

• Published in: American journal of transplantation Vol. 6; no. 4; pp. 842 - 846
• Main Authors: Türk, T., Pietruck, F., Dolff, S., Kribben, A., Janssen, O. E., Mann, K., Philipp, T., Heemann, U., Witzke, O.
• Format: Journal Article
• Language: English
• Published: Oxford UK Blackwell Publishing Ltd 01-04-2006; Blackwell
• Subjects: Biological and medical sciences; Carbamates - therapeutic use; Diabetes Mellitus - drug therapy; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Hypoglycemic Agents - therapeutic use; Kidney Transplantation; Male; Medical sciences; Middle Aged; New‐onset diabetes mellitus; Piperidines - therapeutic use; renal transplantation; repaglinide; Rosiglitazone; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Thiazolidinediones - therapeutic use; Treatment Outcome; Endocrinopathy; New-onset diabetes mellitus; Diabetes mellitus; renal transplantation; Early stage; Homotransplantation; Kidney; Hypoglycemic agent; Clinical management; Treatment; Urinary system; Surgery; Graft; Repaglinide; Kidney transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2006.01250.x

The purpose of this study was to investigate the use of the short‐acting insulin secretion drug repaglinide in new‐onset diabetes mellitus (NODM) after renal transplantation. Twenty‐three Caucasian patients with NODM after renal transplantation were selected to receive repaglinide therapy and were followed for at least 6 months. A control group treated with rosiglitazone was chosen for comparison. Successful repaglinide treatment was defined as a significant improvement of blood glucose concentrations and HbA1c <7% in the absence of glucosuria and without the need for the addition of further anti‐diabetic agents. After 6 months of treatment with repaglinide, 14 of the 23 patients were successfully treated. Mean HbA1c decreased from 7.6 ± 0.6% to 5.8 ± 0.6% in 14 patients treated successfully. In nine patients, hyperglycemia persisted, and they were switched to insulin treatment (HbA1c 8.5 ± 2.9% at the beginning to 7.4 ± 2.2%). Mean serum creatinine levels, cyclosporine A and tacrolimus blood levels did not change significantly following institution of repaglinide therapy. The rate of successful treatment and the degree of HbA1c decrease were similar compared to rosiglitazone‐treated control patients. The data from our observational study indicate that repaglinide can be an effective treatment option in Caucasian patients with NODM after renal transplantation.