Aims
The calcineurin inhibitors cyclosporine and tacrolimus are implicated in post‐transplant complications such as new‐onset diabetes after transplantation. The relative contribution of each calcineurin inhibitor to new‐onset diabetes after transplantation remains unclear. We sought to compare the impact of cyclosporine and tacrolimus on glucose metabolism in humans.
Methods
Eight haemodialysis patients received 8–10 days of oral treatment followed by 5‐h infusions with cyclosporine, tacrolimus and saline in a randomized, investigator‐blind, crossover study. Glucose metabolism and β‐cell function was investigated through: a hyperinsulinaemic–euglycaemic clamp, an intravenous glucose tolerance test and insulin concentration time series.
Results
Cyclosporine and tacrolimus decreased insulin sensitivity by 22% (P = 0.02) and 13% (P = 0.048), respectively. The acute insulin response and pulsatile insulin secretion were not significantly affected by the drugs.
Conclusion
In conclusion, 8–10 days of treatment with cyclosporine and tacrolimus impairs insulin sensitivity to a similar degree in haemodialysis patients, while acute insulin responses and pulsatile insulin secretion remain unaffected.