Management of diabetes mellitus in patients undergoing liver transplantation

Valeria Grancini, Veronica Resi, Eva Palmieri, Giuseppe Pugliese, Emanuela Orsi

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Diabetes is a common feature in cirrhotic individuals both before and after liver transplantation and negatively affects prognosis. Certain aetiological agents of chronic liver disease and loss of liver function per se favour the occurrence of pre-transplant diabetes in susceptible individuals, whereas immunosuppressant treatment, changes in lifestyle habits, and donor- and procedure-related factors contribute to diabetes development/persistence after transplantation. Challenges in the management of pre-transplant diabetes include the profound nutritional alterations characterizing cirrhotic individuals and the limitations to the use of drugs with liver metabolism. Special issues in the management of post-transplant diabetes include the diabetogenic potential of immunosuppressant drugs and the increased cardiovascular risk characterizing solid organ transplant survivors. Overall, the pharmacological management of cirrhotic patients undergoing liver transplantation is complicated by the lack of specific guidelines reflecting the paucity of data on the impact of glycaemic control and the safety and efficacy of anti-hyperglycaemic agents in these individuals.

Original languageEnglish
Pages (from-to)556-573
Number of pages18
JournalPharmacological Research
Volume141
DOIs
Publication statusPublished - Mar 1 2019

Fingerprint

Liver Transplantation
Diabetes Mellitus
Transplants
Immunosuppressive Agents
Cardiovascular Agents
Liver
Habits
Survivors
Life Style
Liver Diseases
Chronic Disease
Transplantation
Tissue Donors
Pharmacology
Guidelines
Safety
Pharmaceutical Preparations
Therapeutics

Keywords

  • Acarbose (PubChem CID: 444254)
  • Anti-hyperglycaemic drugs
  • Canagliflozin (PubChem CID: 24812758)
  • Dapagliflozin (PubChem CID: 9887712)
  • Diabetes mellitus
  • Empagliflozin (PubChem CID: 11949646)
  • Exenatide (PubChem CID: 45588096)
  • Immunosuppressant drugs
  • Lifestyle intervention
  • Linagliptin (PubChem CID: 10096344)
  • Liraglutide (PubChem CID: 16134956)
  • Liver transplantation
  • Metformin (PubChem CID: 4091)
  • Pioglitazone (PubChem CID: 4829)
  • Sitagliptin (PubChem CID: 4369359)

ASJC Scopus subject areas

  • Pharmacology

Cite this

Management of diabetes mellitus in patients undergoing liver transplantation. / Grancini, Valeria; Resi, Veronica; Palmieri, Eva; Pugliese, Giuseppe; Orsi, Emanuela.

In: Pharmacological Research, Vol. 141, 01.03.2019, p. 556-573.

Research output: Contribution to journalReview article

Grancini, Valeria ; Resi, Veronica ; Palmieri, Eva ; Pugliese, Giuseppe ; Orsi, Emanuela. / Management of diabetes mellitus in patients undergoing liver transplantation. In: Pharmacological Research. 2019 ; Vol. 141. pp. 556-573.
@article{0c4c5a2cc6d24e8db9cc81daf4fa2aea,
title = "Management of diabetes mellitus in patients undergoing liver transplantation",
abstract = "Diabetes is a common feature in cirrhotic individuals both before and after liver transplantation and negatively affects prognosis. Certain aetiological agents of chronic liver disease and loss of liver function per se favour the occurrence of pre-transplant diabetes in susceptible individuals, whereas immunosuppressant treatment, changes in lifestyle habits, and donor- and procedure-related factors contribute to diabetes development/persistence after transplantation. Challenges in the management of pre-transplant diabetes include the profound nutritional alterations characterizing cirrhotic individuals and the limitations to the use of drugs with liver metabolism. Special issues in the management of post-transplant diabetes include the diabetogenic potential of immunosuppressant drugs and the increased cardiovascular risk characterizing solid organ transplant survivors. Overall, the pharmacological management of cirrhotic patients undergoing liver transplantation is complicated by the lack of specific guidelines reflecting the paucity of data on the impact of glycaemic control and the safety and efficacy of anti-hyperglycaemic agents in these individuals.",
keywords = "Acarbose (PubChem CID: 444254), Anti-hyperglycaemic drugs, Canagliflozin (PubChem CID: 24812758), Dapagliflozin (PubChem CID: 9887712), Diabetes mellitus, Empagliflozin (PubChem CID: 11949646), Exenatide (PubChem CID: 45588096), Immunosuppressant drugs, Lifestyle intervention, Linagliptin (PubChem CID: 10096344), Liraglutide (PubChem CID: 16134956), Liver transplantation, Metformin (PubChem CID: 4091), Pioglitazone (PubChem CID: 4829), Sitagliptin (PubChem CID: 4369359)",
author = "Valeria Grancini and Veronica Resi and Eva Palmieri and Giuseppe Pugliese and Emanuela Orsi",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.phrs.2019.01.042",
language = "English",
volume = "141",
pages = "556--573",
journal = "Pharmacological Research",
issn = "1043-6618",
publisher = "Academic Press",

}

TY - JOUR

T1 - Management of diabetes mellitus in patients undergoing liver transplantation

AU - Grancini, Valeria

AU - Resi, Veronica

AU - Palmieri, Eva

AU - Pugliese, Giuseppe

AU - Orsi, Emanuela

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Diabetes is a common feature in cirrhotic individuals both before and after liver transplantation and negatively affects prognosis. Certain aetiological agents of chronic liver disease and loss of liver function per se favour the occurrence of pre-transplant diabetes in susceptible individuals, whereas immunosuppressant treatment, changes in lifestyle habits, and donor- and procedure-related factors contribute to diabetes development/persistence after transplantation. Challenges in the management of pre-transplant diabetes include the profound nutritional alterations characterizing cirrhotic individuals and the limitations to the use of drugs with liver metabolism. Special issues in the management of post-transplant diabetes include the diabetogenic potential of immunosuppressant drugs and the increased cardiovascular risk characterizing solid organ transplant survivors. Overall, the pharmacological management of cirrhotic patients undergoing liver transplantation is complicated by the lack of specific guidelines reflecting the paucity of data on the impact of glycaemic control and the safety and efficacy of anti-hyperglycaemic agents in these individuals.

AB - Diabetes is a common feature in cirrhotic individuals both before and after liver transplantation and negatively affects prognosis. Certain aetiological agents of chronic liver disease and loss of liver function per se favour the occurrence of pre-transplant diabetes in susceptible individuals, whereas immunosuppressant treatment, changes in lifestyle habits, and donor- and procedure-related factors contribute to diabetes development/persistence after transplantation. Challenges in the management of pre-transplant diabetes include the profound nutritional alterations characterizing cirrhotic individuals and the limitations to the use of drugs with liver metabolism. Special issues in the management of post-transplant diabetes include the diabetogenic potential of immunosuppressant drugs and the increased cardiovascular risk characterizing solid organ transplant survivors. Overall, the pharmacological management of cirrhotic patients undergoing liver transplantation is complicated by the lack of specific guidelines reflecting the paucity of data on the impact of glycaemic control and the safety and efficacy of anti-hyperglycaemic agents in these individuals.

KW - Acarbose (PubChem CID: 444254)

KW - Anti-hyperglycaemic drugs

KW - Canagliflozin (PubChem CID: 24812758)

KW - Dapagliflozin (PubChem CID: 9887712)

KW - Diabetes mellitus

KW - Empagliflozin (PubChem CID: 11949646)

KW - Exenatide (PubChem CID: 45588096)

KW - Immunosuppressant drugs

KW - Lifestyle intervention

KW - Linagliptin (PubChem CID: 10096344)

KW - Liraglutide (PubChem CID: 16134956)

KW - Liver transplantation

KW - Metformin (PubChem CID: 4091)

KW - Pioglitazone (PubChem CID: 4829)

KW - Sitagliptin (PubChem CID: 4369359)

UR - http://www.scopus.com/inward/record.url?scp=85060723974&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060723974&partnerID=8YFLogxK

U2 - 10.1016/j.phrs.2019.01.042

DO - 10.1016/j.phrs.2019.01.042

M3 - Review article

C2 - 30690071

AN - SCOPUS:85060723974

VL - 141

SP - 556

EP - 573

JO - Pharmacological Research

JF - Pharmacological Research

SN - 1043-6618

ER -