Blood glucose control in a patient with diabetes mellitus after facial composite allotransplantation

Abstract

A facial allotransplanted patient presented hyperglycemia with blood glucose ranged 14. 3 -33. 3 mmol/L after receiving immunosuppressive drugs and glucocorticoids. To control the blood glucose level, the patient was treated with two subcutaneous doses of 10 U human neutral protamine hagedorn (NPH) insulin, and the fasting glucose level came down to 3. 6 - 9. 4 mmol/L. Then the continuous subcutaneous infusion of insulin aspart ( Novo Industri) was administrated (from 96 to 21 U/d) , and the fasting blood glucose levels were 3. 9 -4. 6 mmol/L. With oral administration of Metformin and Repaglinide, the fasting blood glucose was maintained to 4. 3 -5.9 mmol/L. With these medications, the blood glucose level of the patient was under good control and the acute and chronic complications of hyperglycemia were effectively prevented. Key words: Diabetes mellitus; Therapy