Titre du document / Document title

Post-transplantation diabetes is better controlled after conversion from prednisone to deflazacort : a prospective trial in renal transplants

Auteur(s) / Author(s)

YU SEUN KIM ⁽¹⁾ ; MYOUNG SOO KIM ⁽¹⁾ ; SOON IL KIM ⁽¹⁾ ; SEUNG KIL LIM ⁽²⁾ ; HO YUNG LEE ⁽²⁾ ; DAE SUK HAN ⁽²⁾ ; PARK K. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Surgery, Severance Hospital, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul, COREE, REPUBLIQUE DE
⁽²⁾ Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, C.PO. Box 8044, Seoul, COREE, REPUBLIQUE DE

Résumé / Abstract

It is well known that long-term use of steroids plays a decisive role in the development of glucose intolerance and diabetes mellitus (DM). Deflazacort, an oxazoline derivative of prednisolone, has been introduced as a potential substitute for conventional steroids in order to ameliorate glucose intolerance. We initiated a randomized study of conversion from prednisone to deflazacort in kidney transplantation (Tx) recipients presenting with pre-Tx or post-Tx DM to ascertain whether or not the switch to deflazacort would ameliorate the diabetic state. Forty-two recipients in the conversion group were compared with 40 patients on prednisone (the control group) in a prospective manner. The dose reduction of insulin or oral blood glucose-lowering agents, the adequacy of glucose control, and the development of side effects were the criteria for evaluating outcome. In the conversion group, patients were switched to deflazacort at a dose ratio of 6 mg deflazacort to 5 mg prednisone. During the mean follow-up period of 13.2 months, neither graft dysfunction nor acute rejection developed in the conversion group. Improvement in blood glucose control in the conversion group was noted. When the conversion group was stratified into pre- or post-Tx DM, promising effects were clearly evident in the post-Tx DM patients. More than 50 % dose reduction of blood glucose-lowering agents was possible in 42.3 % of post-Tx DM patients. In conclusion, it was readily possible to control blood glucose better in post-Tx DM recipients without seriously affecting the immunosuppressive activity after conversion to deflazacort.

Revue / Journal Title

Transplant international   ISSN 0934-0874 

Source / Source

1997, vol. 10, n^o3, pp. 197-201 (14 ref.)

Langue / Language

Anglais

Editeur / Publisher

Blackwell Publishing, Oxford, ROYAUME-UNI  (1988) (Revue)

Mots-clés anglais / English Keywords

Homograft ; Kidney ; Human ; Steroid ; Immunosuppression ; Complication ; Diabetes mellitus ; Impaired glucose tolerance ; Prevention ; Deflazacort ; Evaluation ; Glycemia ; Corticosteroid ; Kidney disease ; Urinary system disease ; Endocrinopathy ;

Mots-clés français / French Keywords

Homogreffe ; Rein ; Homme ; Stéroïde ; Immunodépression ; Complication ; Diabète ; Anomalie tolérance glucose ; Prévention ; Déflazacort ; Evaluation ; Glycémie ; Corticostéroïde ; Rein pathologie ; Appareil urinaire pathologie ; Endocrinopathie ;

Mots-clés espagnols / Spanish Keywords

Homoinjerto ; Riñón ; Hombre ; Esteroide ; Inmunodepresión ; Complicación ; Diabetes ; Anomalía tolerancia glucosa ; Prevención ; Deflazacort ; Evaluación ; Glucemia ; Corticoesteroide ; Riñón patología ; Aparato urinario patología ; Endocrinopatía ;

Localisation / Location

INIST-CNRS, Cote INIST : 21809, 35400006526371.0050