TY - JOUR
T1 - Management of the Hospitalized Transplant Patient
AU - Boerner, Brian
AU - Shivaswamy, Vijay
AU - Goldner, Whitney
AU - Larsen, Jennifer
N1 - Publisher Copyright:
© 2015, The Author(s).
PY - 2015/4
Y1 - 2015/4
N2 - Significant hyperglycemia is commonly observed immediately after solid organ and bone marrow transplant as well as with subsequent hospitalizations. Surgery and procedures are well known to cause pain and stress leading to secretion of cytokines and other hormones known to aggravate insulin action. Immunosuppression required for transplant and preexisting risk are also major factors. Glucose control improves outcomes for all hospitalized patients, including transplant patients, but is often more challenging to achieve because of frequent and sometimes unpredictable changes in immunosuppression doses, renal function, and nutrition. As a result, risk of hypoglycemia can be greater in this patient group when trying to achieve glucose control goals for hospitalized patients. Key to successful management of hyperglycemia is regular communication between the members of the care team as well as anticipating and rapidly implementing a new treatment paradigm in response to changes in immunosuppression, nutrition, renal function, or evidence of changing insulin resistance.
AB - Significant hyperglycemia is commonly observed immediately after solid organ and bone marrow transplant as well as with subsequent hospitalizations. Surgery and procedures are well known to cause pain and stress leading to secretion of cytokines and other hormones known to aggravate insulin action. Immunosuppression required for transplant and preexisting risk are also major factors. Glucose control improves outcomes for all hospitalized patients, including transplant patients, but is often more challenging to achieve because of frequent and sometimes unpredictable changes in immunosuppression doses, renal function, and nutrition. As a result, risk of hypoglycemia can be greater in this patient group when trying to achieve glucose control goals for hospitalized patients. Key to successful management of hyperglycemia is regular communication between the members of the care team as well as anticipating and rapidly implementing a new treatment paradigm in response to changes in immunosuppression, nutrition, renal function, or evidence of changing insulin resistance.
KW - Bone marrow transplant
KW - Diabetes complication
KW - Diabetes mellitus type 1
KW - Diabetes mellitus type 2
KW - Heart transplant
KW - Hyperglycemia
KW - Kidney transplant
KW - Organ transplant
KW - Rejection
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U2 - 10.1007/s11892-015-0585-6
DO - 10.1007/s11892-015-0585-6
M3 - Review article
C2 - 25721247
AN - SCOPUS:84923770394
SN - 1534-4827
VL - 15
JO - Current diabetes reports
JF - Current diabetes reports
IS - 4
ER -