Role of nutritional therapy on dietary habits and glycemic control in insulin-treated kidney transplant patients with diabetes

Diabetes Res Clin Pract. 2024 May:211:111680. doi: 10.1016/j.diabres.2024.111680. Epub 2024 Apr 23.

Abstract

Aims: To evaluate the effect of nutritional therapy on glycemic compensation and key cardio-renal risk markers in patients with diabetes and kidney transplant, on insulin treatment by Multiple Daily Injection (MDI) or Continuous Subcutaneous Insulin Infusion (CSII).

Methods: 34 patients with diabetes on insulin treatment and kidney transplant recipients were enrolled;12 participated in the structured nutritional program (intervention group), 22 patients (control group) did not receive nutritional protocol. Both groups were then divided into subgroups according to the method of insulin administration (MDI and CSII).

Results: Statistically significant reduction in fasting blood glucose values, glycosylated hemoglobin (HbA1c) and glycosuria were observed in both groups at the end of the study. The intervention group, significantly reduced total cholesterolemia and the glycemic index, together with reduced dietary intake of lipids, cholesterol, soluble carbohydrates and increased consumption of carbohydrates and fiber. These improvements were even more pronounced in patients treated with CSII.

Conclusions: A proper nutritional approach optimize glycometabolic outcomes and contribute significantly to the reduction of the major cardiovascular risk factors in renal transplant patients.

Keywords: Advanced Hybrid Closed Loop; Diabetes complications; Insulin therapy; Lifestyle modification; Medical Nutrition Therapy; Transplant Kidney.

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Feeding Behavior*
  • Female
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism
  • Glycemic Control* / methods
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Insulin* / administration & dosage
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Nutrition Therapy*

Substances

  • Blood Glucose
  • Glycated Hemoglobin
  • Hypoglycemic Agents
  • Insulin