Diabetes Mellitus After Renal Transplantation in the Cyclosporine Era

Sumrani, Nabil; Delaney, Vera; Ding, Zhongkun; Davis, Robert P.; Daskalakis, P.; Friedman, Eli A.; Butt, Khalid M. H.; Hong, Joon Ho

doi:10.1097/00007890-199102000-00014

Cited by 213 publications

(130 citation statements)

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“…Many previous studies have reported that body weight is one of the risk factors for the development of PTDM (1,11,(25)(26)(27), whereas some studies have reported that the associations between PTDM and body weight or BMI are weak (5,20). As BMI is included in the equation for the dependent parameter ISI TX , a higher BMI is likely to be related to a greater reduction in insulin sensitivity.…”

Section: Incidences Of Different Categories Of Ptdmmentioning

confidence: 99%

Risk Factors Associated With the Onset and Progression of Posttransplantation Diabetes in Renal Allograft Recipients

Hur

Kim

et al. 2007

Diabetes Care

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OBJECTIVE -The aim of this study was to assess the incidence of posttransplantation diabetes mellitus (PTDM) in renal allograft recipients and to investigate factors contributing to the onset and progression of PTDM and its underlying pathogenic mechanism(s).RESEARCH DESIGN AND METHODS -A total of 77 patients with normal glucose tolerance (NGT) were enrolled in this study. An oral glucose tolerance test was performed 1 week before transplantation and repeated at 1 and 7 years after transplantation.RESULTS -The overall incidence of PTDM was 39% at 1 year and 35.1% at 7 years posttransplantation. The incidence for each category of PTDM was as follows: persistent PTDM (P-PTDM) (patients who developed diabetes mellitus within 1 year of transplantation and remained diabetic during 7 years), 23.4%; transient PTDM (T-PTDM) (patients who developed diabetes mellitus during the 1st year after transplantation but eventually recovered to have NGT), 15.6%; late PTDM (L-PTDM) (patients who developed diabetes mellitus later than 1 year after transplantation), 11.7%; and non-PTDM during 7 years (N-PTDM 7 ) (patients who did not develop diabetes mellitus during 7 years), 49.3%. Older age (Ն40 years) at transplantation was a higher risk factor for P-PTDM, whereas a high BMI (Ն25 kg/m 2 ) and impaired fasting glucose (IFG) at 1 year posttransplantation were higher risk factors for L-PTDM. Impaired insulin secretion rather than insulin resistance was significantly associated with the development of Pand L-PTDM.CONCLUSIONS -Impaired insulin secretion may be the main mechanism for the development of PTDM. Older age at transplantation seems to be associated with P-PTDM, whereas a high BMI and IFG at 1 year after transplantation were associated with L-PTDM. Diabetes Care 30:609 -615, 2007P osttransplantation diabetes mellitus (PTDM) is a major complication after kidney transplantation and can lead to a wide range of complications including graft loss, increased mortality, increased number of rejections, and increased risk of cardiovascular disease (1-4). A recent meta-analysis of observational studies and randomized, controlled trials showed that the incidence of PTDM during the 1st year after transplantation varied from 2 to 50% (5). There have been several previous reports on PTDM in Korean patients, albeit for a short period of observation. We reported previously that the incidence of PTDM was 23.7% in 114 patients treated with cyclosporine A (CsA) at 9 -12 months after transplantation (6), whereas Cho et al. (7) reported that it was 57.1% in 21 patients treated with tacrolimus at 6 months after transplantation in Korea.PTDM and type 2 diabetes are similar in many ways. One example is that the onset of both can be insidious (8); individuals may experience glucose intolerance and remain asymptomatic for years before symptoms manifest clinically (9,10). Furthermore, PTDM is not always permanent and may resolve within weeks or months, sometimes without treatment (11). Although several recent reports on a consensus definition of PTDM ha...

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Section: Incidences Of Different Categories Of Ptdmmentioning

confidence: 99%

Risk Factors Associated With the Onset and Progression of Posttransplantation Diabetes in Renal Allograft Recipients

Hur

Kim

et al. 2007

Diabetes Care

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“…Similarly, a recent registry analysis of data from Ͼ11,000 patients in the United States Renal Data System (USRDS) found that the risk for NOD increased by 53% when Tac was used as the initial maintenance immunosuppression (2). Another large registry study found that the difference in NOD between CsA and Tac occurs as soon as 3 mo after transplantation (3), a result confirmed by subsequent clinical trials (15)(16)(17).…”

mentioning

confidence: 92%

Influence of Early Posttransplantation Prednisone and Calcineurin Inhibitor Dosages on the Incidence of New-Onset Diabetes

Burroughs¹,

Lentine²,

Takemoto³

et al. 2007

Clinical Journal of the American Society of Nephrology

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“…신장이식 환자에서도 40세 이상일 경우 이식 후 당뇨병의 발생이 증가하는 것으로 알려져 있고 [8,9], 이식 당시 나이가 60세 이상이면 젊은 사람에 비해 이식 후 당 뇨병이 2.6배 더 많이 발생한다는 보고가 있다 [10]. 또한 40세 이상의 높은 연령대는 이식 후 발생한 당뇨병이 정상 혈당으로 회복되지 않고 지속되는 중요한 고 위험 인자이 다 [11].…”

Section: 연령unclassified

“…한 연구에 따르면 신장이식을 받은 환자의 11.6%에 서 이식 후 당뇨병이 발생하였는데, 이 중 히스패닉계 인 종은 21.3%, 흑인은 19.8%, 동양인은 4.8%의 발병률을 보 였다 [8].…”

Section: 인종unclassified

Management of Diabetes in Organ Transplant Patients

Yun

Kang

2014

J Korean Diabetes

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New onset diabetes after transplantation (NODAT) is a common complication after solid-organ transplantation and is associated with increased cardiovascular morbidity, mortality, and graft loss. The risk factors for NODAT include older age, ethnicity, genetic factors,obesity, family history of diabetes, hepatitis C virus infection, and immunosuppressant use (corticosteroids, calcineurin inhibitors, and mTOR inhibitor). Management of NODAT must be considered at the pre-transplantation stage in order to properly screen high-risk patients. Although NODAT management is similar to that of general type 2 diabetes, some specific considerations must be made in NODAT management, including the interactions between anti-diabetes medication and immunosuppressive agents. (J Korean Diabetes 2014;15:134-141)

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Diabetes Mellitus After Renal Transplantation in the Cyclosporine Era

Cited by 213 publications

References 0 publications

Risk Factors Associated With the Onset and Progression of Posttransplantation Diabetes in Renal Allograft Recipients

Risk Factors Associated With the Onset and Progression of Posttransplantation Diabetes in Renal Allograft Recipients

Influence of Early Posttransplantation Prednisone and Calcineurin Inhibitor Dosages on the Incidence of New-Onset Diabetes

Management of Diabetes in Organ Transplant Patients

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