A Randomized Controlled Trial to Evaluate the Effect of Glycemic Control on Renal Transplantation Outcomes

Context: Outcomes from intensive glycemic control postrenal transplant have not been studied. Objective: Our objective was to observe the optimal management of hyperglycemia in patients with diabetes or impaired glucose tolerance receiving renal transplantation. Design, Setting, and Patients: We conducted a randomized controlled trial with patients undergoing renal transplantation randomized to either iv insulin therapy (intensive) or standard sc insulin therapy while the patients were admitted to the hospital. Interventions: The study consisted of a 3-day postrenal transplant group treated with intensive iv insulin [blood glucose (BG) = 70–110 mg/dl] or a control group treated with sc insulin (BG = 70–180 mg/dl). Main Outcome Measure: The primary endpoint was delayed graft function (DGF). Secondary endpoints were glycemic control, graft survival, and acute rejection episodes. Results: A total of 104 patients were screened and randomized to either the intensive or control condition; however, the intention...