Post-transplantation diabetes: Treatment à la carte ?

Benomar, Kanza; Espiard, Stéphanie; Vahé, Claire; Mapihan, Kristell Le; Jannin, Arnaud; Dharancy, Sébastien; Hazzan, Marc; Vantyghem, Marie-Christine

doi:10.1016/j.diabet.2016.09.011

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Of course, the presence of ketoacidosis or HbA1c > 7%, with a basal fasting blood glucose > 140 mg/dL and 2-h postprandial glucose > 180 mg/dL, require antidiabetic treatment. Yet, in practice, the loss of insulin independence with 14 detectable C-peptide (in general, > 0.5 ng/mL) when HbA1c increases to > 6.5% without insulin is considered and treated as post-transplantation diabetes until optimal insulin therapy is fully resumed with gradually increasing increments of oral antidiabetic drugs [35].…”

Section: Insulin Independence With Normal Hba1cmentioning

confidence: 99%

Indications for islet or pancreatic transplantation: Statement of the TREPID working group on behalf of the Société francophone du diabète (SFD), Société francaise d’endocrinologie (SFE), Société francophone de transplantation (SFT) and Société française de néphrologie – dialyse – transplantation (SFNDT)

Wojtusciszyn

Branchereau

Esposito³

et al. 2019

Diabetes & Metabolism

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While either pancreas or pancreatic islet transplantation can restore endogenous insulin secretion in patients with diabetes, no beta-cell replacement strategies are recommended in the literature. For this reason, the aim of this national expert panel statement is to provide information on the different kinds of beta-cell replacement, their benefit-risk ratios and indications for each type of transplantation, according to type of diabetes, its control and association with end-stage renal disease. Allotransplantation requires immunosuppression, a risk that should be weighed against the risks of poor glycaemic control, diabetic lability and severe hypoglycaemia, especially in cases of unawareness. Pancreas transplantation is associated with improvement in diabetic micro- and macro-angiopathy, but has the associated morbidity of major surgery. Islet transplantation is a minimally invasive radiological or mini-surgical procedure involving infusion of purified islets via the hepatic portal vein, but needs to be repeated two or three times to achieve insulin independence and long-term functionality. Simultaneous pancreas-kidney and pancreas after kidney transplantations should be proposed for kidney recipients with type 1 diabetes with no surgical, especially cardiovascular, contraindications. In cases of high surgical risk, islet after or simultaneously with kidney transplantation may be proposed. Pancreas, or more often islet, transplantation alone is appropriate for non-uraemic patients with labile diabetes. Various factors influencing the therapeutic strategy are also detailed in this report.

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Section: Insulin Independence With Normal Hba1cmentioning

confidence: 99%

Indications for islet or pancreatic transplantation: Statement of the TREPID working group on behalf of the Société francophone du diabète (SFD), Société francaise d’endocrinologie (SFE), Société francophone de transplantation (SFT) and Société française de néphrologie – dialyse – transplantation (SFNDT)

Wojtusciszyn

Branchereau

Esposito³

et al. 2019

Diabetes & Metabolism

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Comprehensive lifestyle modification as complementary therapy to prevent and manage post-transplant diabetes mellitus^*

Madziarska

Hap

Mazanowska

et al. 2021

Postępy Higieny I Medycyny Doświadczalnej

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Post-transplant diabetes mellitus (PTDM) is one from the most common metabolic complications after kidney transplantation. PTDM develops in the early period after transplantation. The risk factors of PTDM are carbohydrate imbalances occurring in the patient prior to transplantation, surgery and the inclusion of immunosuppressive treatment. Kidney transplant patients tend to gain weight, which is associated with an increased risk of post-transplant diabetes, cardiovascular diseases and abnormal transplanted kidney function. Patients after kidney transplantation should be advised to adopt a lifestyle based on a proper diet, exercise, weight control and smoking cessation. The strategy to reduce the risk factors for PTDM development should start before transplantation and continue after kidney transplantation. A targeted, non-pharmacological approach to patients already during the dialysis period may have a significant impact on reducing post-transplantation diabetes. Lifestyle interventions can effectively reduce the risk of development and inhibit the progression of post-transplantation diabetes. The article describes elements of comprehensive non-pharmacological management based on available knowledge of rehabilitation, dietetics and psychology.

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Post-transplantation diabetes: Treatment à la carte ?

Cited by 2 publications

References 16 publications

Comprehensive lifestyle modification as complementary therapy to prevent and manage post-transplant diabetes mellitus^*

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Post-transplantation diabetes: Treatment à la carte ?

Cited by 2 publications

References 16 publications

Comprehensive lifestyle modification as complementary therapy to prevent and manage post-transplant diabetes mellitus*

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Resources

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Comprehensive lifestyle modification as complementary therapy to prevent and manage post-transplant diabetes mellitus^*