Linagliptin in Post-renal Transplantation
Linagliptin in Post-renal Transplantation
Post-renal transplanted patients frequently present hyperglycemia immediately after the
 procedure.

 This was a retrospective comparative study performed in post-renal transplanted patients in a
 single high speciality center with the goal of compare the effect of linagliptin + insulin in
 post-renal transplanted patients with hyperglycemia Interventions were linagliptin 5mg daily
 plus insulin vs insulin alone during 5 days after renal transplantation with hyperglycemia,
 and the main outcome were glucose levels, insulin dose and severity of hypoglycemia
This was a retrospective comparative study performed in a single center between 2016 and
 2018, included the data collected from 28 hospitalized post-renal transplanted patients that
 presented hyperglycemia (>140 mg/dl or or 7.77 mmol/l) immediately after renal
 transplantation (RT); 14 patients were treated with linagliptin 5mg daily plus a basal bolus
 insulin scheme prescribed by the Endocrinology group at the hospital, and 14 patients treated
 only with basal bolus insulin scheme were randomly selected from a list of patients treated
 during the same period of time and by the same Endocrinology group. Linagliptin dose was 5mg
 daily and the basal bolus insulin regimen was started and adjusted according to the
 international guidelines; in general, patients received a starting insulin dose of around 0.5
 U/kg/day, given half as basal insulin (NPH or Glargine) once or twice daily and half as
 insulin lispro divided into three equal doses before meals. Insulin dose was adjusted daily
 to achieve the goal of fasting glucose between 80-140 mg/dl (4.44-7.77 mmol/l) or random
 glucose levels below 180 mg/dl (9.99 mmol/l). Correctional insulin dose was used before each
 meal, depending on the glucose measurements, starting at 1 unit for each 40mg above 140 mg/dl
 (7.77 mmol/l) of glucose. Glucose levels were monitored at fasting and before each meal, as
 well as at bedtime according to standard clinical practice. Data regarding fasting and
 preprandial glucose levels, hypoglycemia, renal function, and immunosuppression therapy were
 recorded from the patient´s file during the first 5 days after RT; fasting glucose and renal
 function were also recorded at 1, 6 and 12 months after RT. Patients were included if they
 were between 18-65 years of age and presented fasting hyperglycemia (>140 mg/dl or 7.77
 mmol/l) immediately after RT.

 Ethical and Research committee (CEI) at the Hospital approved the study protocol with the
 number CEI-49-18.
Inclusion Criteria:

 -  Hyperglycemia (glucose levels above 140 mg/dl) immediately after renal transplantation

 Exclusion Criteria:

 -  Incomplete records on the patients file

 -  Acute complications such as liver failure