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Prior diabetes mellitus is associated with increased morbidity in cystic fibrosis patients undergoing bilateral lung transplantation: an ‘orphan’ area? A retrospective case–control study
Author(s) -
Bradbury R. A.,
Shirkhedkar D.,
Glanville A. R.,
Campbell L. V.
Publication year - 2009
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2008.01786.x
Subject(s) - medicine , diabetes mellitus , cystic fibrosis , lung transplantation , retrospective cohort study , transplantation , complication , surgery , cystic fibrosis related diabetes , lung , impaired glucose tolerance , type 2 diabetes , endocrinology
Background: The aim of this study was to determine whether pre‐existing diabetes mellitus increases the risk of rejection, infection and/or death in cystic fibrosis patients undergoing bilateral sequential single‐lung transplantation. Methods: A retrospective audit of 25 consecutive patients with cystic fibrosis who underwent bilateral sequential single‐lung transplantation between 1 January 2003 and 31 December 2005 at a tertiary referral hospital was carried out. Results: Although 32% patients had diabetes diagnosed before lung transplantation, 92% had random blood glucose levels ≥11.1 mmol/L requiring insulin during admission. Patients with pre‐existing diabetes had increased infection‐related (3.9 vs 1.2, P = 0.01) and putative rejection‐related (1.4 vs 0.5, P = 0.04) hospital admissions post‐transplantation compared with those without diabetes pre‐transplant. During the period of observation, four of eight patients with a prior diagnosis of diabetes died compared with none of 17 patients without prior diabetes ( P = 0.0055). Conclusion: Almost all cystic fibrosis patients develop hyperglycaemia after lung transplantation, but patients with prior diabetes have more complication‐related admissions to hospital and a higher mortality rate.