Pre-emptive insulin therapy reduces risk of diabetes mellitus after kidney transplantation

Up to 30 percent of all patients develop diabetes mellitus within the first year after a kidney transplantation. This high rate could soon fall rapidly. A Medical University of Vienna research team at Vienna General Hospital's University Department of Internal Medicine III has discovered in the context of a study that pre-emptive insulin therapy drastically reduces this rate.

"We give the patients insulin immediately after the transplant even before diabetes mellitus occurs. The new thing about this is that we are giving insulin to non-diabetics and are hereby treating patients preventatively", explains Marcus Säemann from the Clinical Department of Nephrology and Dialysis. This has been a success; in a group of 25 patients who were treated with insulin therapy for the three months immediately following a transplant, the risk of developing diabetes could be reduced by around 75 percent. In the control group, which had been treated according to current care standards over the same period, over 45 percent developed diabetes within one year of the transplant. Manfred Hecking, study supervisor says, "This is sensational data that we have obtained from thousands of blood sugar measurements."

A multicenter study managed by MedUni Vienna

The first results of the study also received such great international attention that the MedUni Vienna could attract the University of Michigan (USA) as a cooperation partner. From the end of 2011 the results shall be expanded upon in a multicenter study sponsored by the US National Institutes of Health (NIH). The three to five year Vienna study shall be coordinated under the leadership of Säemann and Hecking, and further centres in Europe, for example in France, Spain, Italy and Germany, shall take part. 

Diabetes mellitus in the first year following a transplant is predominantly caused by the stress from the operation and the initially high dose of the immunosuppression which is necessary to prevent acute rejections. Säemann says, "The patient shall be, so to say, swept away from a wave of acute disease." New onset diabetes following a transplant significantly reduces the patient's life expectancy and their quality of life. Furthermore it also reduces the life of the transplant. Until now this specific form of diabetes could not be treated effectively nor avoided. "Our study is a great advance for transplant medicine generally." Currently around 1,100 patients are being treated as outpatients following a kidney transplant at the Vienna General Hospital.