New Onset Diabetes Mellitus after Transplantation (NODAT)-An Analysis of Incidence, Risk Factors and its Effects on Renal Allograft

Abstract

Aim: New Onset Diabetes after Transplantation (NODAT) is one of the medical complications after kidney transplantation which affects adversely the allograft kidney and patient outcomes. The aim of this study was to know the incidence of development of NODAT, investigate risk factors and its effects on allograft kidney in our centre.Material and methods: This is a retrospective observational study of the patients who underwent the kidney transplant at the Narayana Medical College & Hospital from June 2009 to May 2016. Patients were divided into NODAT and non NODAT groups.Results: 21 out of 84 patients (25%) developed NODAT during the follow up period of 1st year post transplantation. We found age >30 years (OR: 3.8; P=0.012), family history of diabetes (OR: 8.6; P=0.0004), impaired fasting glucose (OR: 7.27; P=0.0003), postoperative hyperglycaemia (OR: 2.83; P=0.04), fasting triglycerides >150 mg/dl. (OR: 8.0 P=0.0001) and VLDL levels (42.52 ± 30.81 mg/dl. vs. 24.24 ± 5.51 mg/dl; P= 0.01) were risk factors for NODAT. Mean serum creatinine values were 1.23 ± 0.25 mg/dl vs.1.16 ± 0.35mg/dl (P= 0.42) and 1.61 ± 0.53 mg/dl vs. 1.44 ± 0.54 mg/dl (P= 0.24) at the end of 1st month and 1st year post-transplantation in NODAT and non NODAT groups respectively.Conclusion: The cumulative incidence of NODAT was 25% by the end of the1st post-transplantation year. Increasing age, family history of diabetes, dyslipidemia, pre-transplantation impaired fasting glucose and postoperative hyperglycaemia were considered as risk factors, some of which can be quite modifiable.