Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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To Study the Efficacy and to Compare Conventional Insulin Versus DPP IV Inhibitor Linagliptin Versus Sulfonylurea Glimepiride in the Treatment of New Onset Diabetes After Transplant (NODAT)
Kairavi Bhardwaj, D.K. Agarwal and C.M. Batra
Page: 498-505 | Received 20 Mar 2024, Published online: 25 May 2024
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Abstract
Solid organ transplantation is currently an important option for the treatment of many types of organ failure, including kidney, liver, heart, pancreas, lung and small bowel. Out of these, kidney transplant is one of the most frequently conducted throughout the world. Renal transplantation has become a great success story overall, mainly because kidney transplant recipients (KTRs) benefit from increased survival rates and higher quality of life compared with dialysis patients. To determine the efficacy of available treatment options for New Onset Diabetes after Transplant (NODAT) by a comparative prospective study between Conventional Insulin regime versus DPP IV inhibitor Linagliptin versus Sulfonylurea Glimepiride. To compare the three study groups in terms of their role, effectiveness, side effects and treatment outcome in duration of three months after start of treatment in newly diagnosed NODAT cases. Hospital based prospective, observational study conducted in Indraprastha Apollo Hospital New Delhi for a period of 2 years between June 2017 to May 2019. Statistical analysis: The results are presented in frequencies, percentages and mean±SD. The Chi‐square test was used to compare categorical variables among the groups. The one way analysis of variance (ANOVA) followed by Tukey’s post hoc tests was used to compare continuous variables among the groups. The p‐value<0.05 was considered significant. All the analysis was carried out on SPSS 16.0 version (Chicago, Inc., USA). Three groups of 20 patients each were created and categorized as: Group A for Insulin, Group B for Glimepride and Group C for Linagliptin. Efficiency wise, Insulin brought down the sugars to the maximum extent as compared to Glimepride and Linagliptin. Glimepride and Linagliptin had comparable efficacy with Glimepride showing slightly better results in some cases. However, Glimepride also showed incidents of hypoglycemia especially in patients with deranged kidney function. Linagliptin alone was not effective in 3 of its patients so those had to be supplemented with some other oral hypoglycemia agent at the end of three months. This study concluded the potency of the three testing drugs in achieving glyceric control as follows: Insulin (Group A)>Glimepride (Group B) >Linagliptin (Group C).Insulin to be the preferred drug in uncontrolled hyperglycemia, sick complicated states, hospitalized patients and in early post‐transplant period. Glimepiride to be used cautiously in patients with deranged renal parameters as it causes more incidence of hypoglycemia. Linagliptin is safe and efficacious in all cases, preferred 1st line drug in mild cases with stable sugars and as an adjunct to other hypoglycemia drugs.
How to cite this article:
Kairavi Bhardwaj, D.K. Agarwal and C.M. Batra. To Study the Efficacy and to Compare Conventional Insulin Versus DPP IV Inhibitor Linagliptin Versus Sulfonylurea Glimepiride in the Treatment of New Onset Diabetes After Transplant (NODAT).
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.6.498.505
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.6.498.505