Diabetes Mellitus and Transplantation: Risks for Post-transplant Diabetes

Abstract

New onset diabetes mellitus after transplantation (NODAT) is a serious and frequently observed complication following solid organ transplantation. Kidney transplant recipients who develop NODAT are at increased risk of fatal and non-fatal cardiovascular events and other adverse outcomes including infection, reduced patient survival, graft rejection, and accelerated graft loss compared with those who do not develop diabetes. Identification of high-risk patients and implementation of measures to reduce the development of NODAT may improve long-term patient and graft outcome. The following chapter presents an overview of the literature on the current diagnostic criteria for NODAT, its incidence after solid organ transplantation, suggested risk factors, and potential pathogenic mechanisms. The impact of NODAT on patient and allograft outcomes and suggested guidelines for early identification and management of NODAT will also be discussed.