The Progression of Hyperglycemia and Diabetes Before and After Lung Transplant

Diabetes mellitus (DM) is a frequent complication of organ transplantion . The aim of the study was to determine the incidence and prevalence of DM after Lung Transplant (LTx).

Methods: Chart review of patients undergoing LTx at the University of Florida, Gainesville between 2013 and 2015. Variables such as diabetes status before and after LTx, glucose level (G) during first seven days after LTx, insulin therapy and other relevant factors were included.

Results: There were 81 LTx surgeries corresponding to 78 patients (3 had repeat LTX). Prior to LTx 14 patients had DM (5 CF), only 2 them were taking insulin, both had CF. G >200 mg/dl and <70mg/dl were observed in 71% (58/81) and 19% (16/81) patients during the first 7 days after LTx respectively. At LTx surgery discharge, 35% (29/81) were on insulin, 51% of them (15/29) on basal insulin alone or in combination. After 12m from LTx, 26 were on insulin, 69% of them (18/26) on basal insulin alone or in combination. Among those who had G>200mg/dl within the first 7 days, only 19% (11/58) had been diagnosed of DM before LTX, and 45% of them (26/58) were taking DM medications 12 months after LTx, and 65% (17/26) were using basal insulin alone or in combination.

Conclusion: Inpatient hyperglycemia is very common after LTx. Use of insulin at discharge is a strong predictor for use of insulin 12m after LTX, indicating the need for close monitoring.