Hyperglycemia During the Immediate Period Following Liver Transplantation

Figures & data

Figure 1.  Comparison of glucose levels according to pretransplant diabetes mellitus status.

(A) Patient-stay mean glucose (BedGluc_avg). (B) Frequency of hyperglycemia. (C) Frequency of hypoglycemia between persons with and without pretransplant DM.

DM: Diabetes mellitus; POC-BG: Point-of-care blood glucose.

Figure 2.  Mean point-of-care glucose values for the first 24 h (F24BedGluc_avg), the midpoint (M24BedGluc_avg) and the last 24 h (L24BedGluc_avg) of the hospital stay following liver transplant, according to pretransplant status of diabetes mellitus.

See text for values and statistical comparisons.

DM: Diabetes mellitus.

Figure 3.  Use of inpatient insulin in liver transplant patients, according to pretransplant diabetes mellitus status.

(A) Percentage of patients receiving insulin during the hospital stay and the proportion discharged on insulin therapy. (B) Type of insulin regimen used during the hospital stay.

DM: Diabetes mellitus.

Table 1.  Demographics of patients undergoing liver transplant, according to diabetes mellitus status.

	Pretransplant DM			No DM pretransplant (n = 250)	p-value^†
Characteristic	All patients (n = 96)	Insulin (n = 60)	Diet or oral agents (n = 36)
Age, mean (SD), years	56 (9)	56 (10)	56 (8)	54 (9)	0.04
Male sex	64 (67)	42 (65)	25 (69)	168 (67)	0.93
White race	81 (84)	50 (83)	31 (86)	220 (88)	0.38
BMI, mean (SD), kg/m^2	29.8 (6.6)	28.7 (5.9)	31.6 (7.4)	28.2 (5.6)	0.04
HbA1c, mean (SD),%	6.2 (1.2)	6.4 (1.3)^‡	5.8 (1.0)^§	NA
Length of stay following transplant, mean (SD), days	13 (12)	14 (14)	12 (9)	12 (10)	0.50
Cause of ESLD:					<0.01
– Alcohol	20 (21)	10 (17)	10 (28)	38 (15)
– Autoimmune disease	6 (6)	3 (5)	3 (8)	44 (18)
– Cryptogenic/other	14 (15)	11 (18)	3 (8)	25 (10)
– NASH	16 (17)	9 (15)	7 (19)	17 (7)
– Viral infection	40 (42)	27 (45)	13 (36)	126 (50)
Cadaveric donor	86 (90)	52 (87)	34 (94)	195 (78)	<0.01

Values are presented as number and percentage of patients unless specified otherwise.

† Comparing pretransplant DM versus no pretransplant DM.

‡ Data available in 43 patients.

§ Data available in 24 patients.

DM: Diabetes mellitus; ESLD: End-stage liver disease; HbA_1c: Hemoglobin A_1c; NA: Not available; NASH: Nonalcoholic steatohepatitis.

Table 2.  Variables associated with being discharged on insulin therapy (versus no insulin therapy) in liver transplant patients without a pretransplant history of diabetes mellitus.

Characteristic	OR (95% CI)	p-value
Age (years)^†	1.22 (1.04–1.44)	0.01
POC-BG >180 mg/dl^‡	1.51 (1.22–1.95)	<0.01
BMI (kg/m^2)	1.02 (0.98–1.08)	0.30
White race (vs nonwhite race)	1.31 (0.55–3.15)	0.54
Male sex (vs female sex)	1.04 (0.57–1.88)	0.89
Cause of ESLD (viral vs nonviral)	1.09 (0.62–1.94)	0.76

† Per 5-year increase.

‡ Per 5-unit increase.

ESLD: End-stage liver disease; OR: Odds ratio; POC-BG: Point-of-care blood glucose.