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

Authors
 Yu Seun Kim  ;  Myoung Soo Kim  ;  Soon II Kim  ;  Kiil Park  ;  Seung Kil Lim  ;  Ho Yung Lee  ;  Dae Suk Han 
Citation
 TRANSPLANT INTERNATIONAL, Vol.10(3) : 197-201, 1997 
Journal Title
 TRANSPLANT INTERNATIONAL 
ISSN
 0934-0874 
Issue Date
1997
MeSH
Adult ; Blood Glucose/metabolism ; Body Weight ; Diabetes Mellitus/drug therapy* ; Female ; Glycated Hemoglobin A/metabolism ; Humans ; Immunosuppressive Agents/therapeutic use* ; Kidney Transplantation* ; Male ; Middle Aged ; Prednisone/therapeutic use* ; Pregnenediones/therapeutic use* ; Prospective Studies
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 a 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.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1432-2277.1997.tb00685.x?sid=vendor%3Adatabase
DOI
10.1007/s001470050041
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Lim, Sung Kil(임승길)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/177418
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