{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:13Z","timestamp":1787013733582,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anecdotally, patients with diabetes mellitus after undertaking a liver transplant have reported improved glycaemic control and reduced insulin requirements, compared to other organ transplants where glycaemic control often worsens. This study aimed to evaluate possible changes in anti\u2010glycaemic agent requirements pre\u2010 and post\u2010liver transplantation and correlate them with the immunosuppression used and the reason for transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this observational, retrospective study, we investigated 258 adults with pre\u2010existing diabetes mellitus who underwent liver transplant from October 2009 to January 2020 at a tertiary UK center. We compared pre\u2010 and post\u2010transplant insulin treatment requirements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age was 56\u2009years, and the median duration of diabetes was 96\u2009months. From a subgroup of 100 patients (38.8%) using insulin therapy, there was a reduction in insulin requirements from 60.5\u2009\u00b1\u200944.6\u2009units\/day before transplant to 51.1\u2009\u00b1\u200931.2\u2009units\/day at 1 month post\u2010transplantation (15.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), 43.4\u2009\u00b1\u200929.5\u2009units\/day at 3 months post\u2010transplantation (28.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and 33.6\u2009\u00b1\u200929.7\u2009units\/day at 6 months post\u2010transplantation (44.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). There was a significant correlation between the difference in insulin requirement before and 6\u2009months post\u2010transplant and the tacrolimus dose used as immunosuppressive therapy post\u2010liver transplant. There was no correlation with the use of other immunosuppressive therapies and change in insulin requirement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Insulin requirements significantly reduced post\u2010liver transplant by almost 50%, despite initiation of immunosuppressive therapy. This is one of the first studies showing this effect, highlighting the role of the liver in regulating glucose metabolism, insulin utilization, and insulin resistance. Pooled data from other specialist centers need to be examined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1753-0407.70088","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T02:47:19Z","timestamp":1752634039000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Effect of Liver Transplantation on Anti\u2010Glycaemic Agents in Patients With Pre\u2010Existing Diabetes Mellitus: A Population\u2010Based Cohort Study"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1035-4027","authenticated-orcid":false,"given":"Amy","family":"Coulden","sequence":"first","affiliation":[{"name":"University Hospitals Birmingham NHSFT  Birmingham UK"},{"name":"The Department of Metabolism and Systems Science, College of Medicine and Health University of Birmingham  Birmingham 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