Decreased insulin secretion in patients receiving tacrolimus as GVHD prophylaxis after allogeneic hematopoietic SCT

Fuji, Shigeo; Kim, S. W.; Mori, Shin Ichiro; Furuta, Koh; Tanosaki, Ryuji; Heike, Yuji; Takaue, Yoichi; Fukuda, Takahiro

doi:10.1038/bmt.2009.154

Cited by 7 publications

(3 citation statements)

References 7 publications

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“…CNIs remain the standard of care as maintenance immunosuppression in renal transplantation for the last four decades since the discovery of cyclosporine [25]. Diabetogenic potential of CNIs is explained by impaired insulin secretion, increased islet cell apoptosis, and decreased beta cell mass [17, 26, 27]. Cyclosporine and tacrolimus are the two main CNIs used in renal transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

Post-Transplant Diabetes Mellitus in Renal Transplant Recipients, Single-Centre Data: Incidence, Risk Factors, and Effect on Graft Function and Mortality

Kumar¹,

Gulzar²,

Alalawi³

et al. 2023

Dubai Diabetes Endocrinol J

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Background: De novo post-transplant diabetes mellitus (PTDM) is a frequent complication among renal transplant recipients; it confers a high risk for graft failure and patient mortality. This single-centre study aimed to determine the incidence and risk factors of PTDM and its effects on graft outcome and mortality. Methods: In a single-centre longitudinal cohort analysis of 383 non-diabetic renal transplant follow-up recipients, outcomes were analysed through a detailed chart review. We hypothesized that different donor and recipient characters such as age, gender, and HLA mismatch would affect PTDM development in renal transplant recipients. PTDM is defined on basis of fasting plasma sugar (≥7 mmol/L or ≥126 mg/dL), random plasma sugar (≥11.1 mmol/L or ≥200 mg/dL), and glycated haemoglobin (HBA1C: >6.5% or 48 mmol/mol). We assessed PTDM incidence, risk factors, and its effect on patient mortality and graft outcome using Cox regression. Results: The mean age at the time of transplantation was 35.70 (±14.27) years, and 50.91% were male. PTDM incidence in the study period was 23.30%. Independent risk factors include older age at the time of transplantation, cyclosporine immunosuppression, cytomegalovirus, and hepatitis C virus infection. PTDM is not associated with graft dysfunction, whereas it significantly carries high mortality. Conclusion: PTDM is common among renal transplant recipients. Older age at the time of transplantation, cyclosporine immunosuppression, cytomegalovirus, and hepatitis C virus are risk factors. PTDM carries high mortality but is not associated with graft failure.

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Section: Discussionmentioning

confidence: 99%

Post-Transplant Diabetes Mellitus in Renal Transplant Recipients, Single-Centre Data: Incidence, Risk Factors, and Effect on Graft Function and Mortality

Kumar¹,

Gulzar²,

Alalawi³

et al. 2023

Dubai Diabetes Endocrinol J

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“…CNIs are thought to promote the development of PTDM through multiple mechanisms. CNIs have been shown to impair insulin secretion in clinical studies of patients receiving tacrolimus [40]. Both animal and human studies, analysing pancreatic histology sections, have demonstrated increased islet cell apoptosis and decreased beta cell mass in groups receiving CNIs [41,42].…”

Section: Calcineurin Inhibitors (Cnis)mentioning

confidence: 99%

Post-Transplantation Diabetes Mellitus

et al. 2020

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Solid organ transplantation (SOT) is an established therapeutic option for chronic disease resulting from end-stage organ dysfunction. Long-term use of immunosuppression is associated with posttransplantation diabetes mellitus (PTDM), placing patients at increased risk of infections, cardiovascular disease and mortality. The incidence rates for PTDM have varied from 10 to 40% between different studies. Diagnostic criteria have evolved over the years, as a greater understating of PTDM has been reached. There are differences in pathophysiology and clinical course of type 2 diabetes and PTDM. Hence, managing this condition can be a challenge for a diabetes physician, as there are several factors to consider when tailoring therapy for post-transplant patients to achieve better glycaemic as well as long-term transplant outcomes. This article is a detailed review of PTDM, examining the pathogenesis, diagnostic criteria and management in light of the current evidence. The therapeutic options are discussed in the context of their safety and potential drug-drug interactions with immunosuppressive agents.

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“…The finding that the C-peptide level at day 28 was significantly lower than that before transplantation was consistent with our previous report. 15 Such insufficient insulin production is also an important factor for the development of hyperglycemia. In terms of calcineurin inhibitors, patients' glycemic status did not differ significantly whether they were receiving tacrolimus or cyclosporine, but this may have been due to the limited number of patients who received cyclosporine as GVHD prophylaxis, as shown in Table 1.…”

mentioning

confidence: 99%

Dynamic change of glycemic status during the early phase after allogeneic hematopoietic stem cell transplantation

Fuji¹,

Yakushijin²,

Sw³

et al. 2015

Bone Marrow Transplant

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Decreased insulin secretion in patients receiving tacrolimus as GVHD prophylaxis after allogeneic hematopoietic SCT

Cited by 7 publications

References 7 publications

Post-Transplant Diabetes Mellitus in Renal Transplant Recipients, Single-Centre Data: Incidence, Risk Factors, and Effect on Graft Function and Mortality

Post-Transplant Diabetes Mellitus in Renal Transplant Recipients, Single-Centre Data: Incidence, Risk Factors, and Effect on Graft Function and Mortality

Post-Transplantation Diabetes Mellitus

Dynamic change of glycemic status during the early phase after allogeneic hematopoietic stem cell transplantation

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