Diabetes since liver transplant

[rbahuguna]

I had liver transplant (receipient) done a month back in Delhi, India. At ten in the morning I take 17 mg of Wysolone. I also take 750 mg Cellcept and 2 mg PanGraf in the morning and same dose in the evening. My sugar level seems to shoot up at times each and every day. I have noticed that around lunch time it starts to shoot up from normal of 110 to 250 within an hour and even without / before any new food or bevereage intake - that is glucose rises around 1 PM without any new meal being yet taken in. So I have to take insulin shot - 12 unit of quick acting Humalog. In the evening it does not shoot up by itself. Only after dinner, it goes up from around 115 to 200 and then return by itself to  normal in three hours time. I take small shot - three units of Humalog - anyway. During breakfast, glucose level behaves best - rising from around 100 to a much lower value, say may be 140, and then starts falling back to where it started from in two hours time. Any advise as to how to minimise this - apparantly medicine induced - Diabetes? Seems like Wysolone is the real culprit. Can I expect a lower dose of it in future as body adjusts to new Liver?

[Thomas D Schiano, MD]

i presume Wysolone is a steroids, whcih clearly causes and worsens diabetes.  almost liver transplant centers try to wean their patients completely off of this as time goes on so possibly your sugars may still go up and down.  expect that they will be lower when the dose of wysolone is decreased.  pangraf can also cause high blood sugars.  many patients have diabetes early after transplant and then it improves or resolves.