Abstract
Post-transplant diabetes mellitus is a major complication after transplantation and is associated with reduced allograft and patient survival.(1) It is hard to quantify the incidence of PTDM because of lack of standard definition and PTDM can occur many years after transplantation. A consensus conference in 2013, defined PTDM as newly diagnosed persistent diabetes mellitus among clinically stable posttransplant patients.
Highlights
Post-transplant diabetes mellitus is a major complication after transplantation and is associated with reduced allograft and patient survival.(1) It is hard to quantify the incidence of PTDM because of lack of standard definition and PTDM can occur many years after transplantation
Multiple risk factors contribute to the development of diabetes after transplantation including: immunosuppressive agents, age, family history, other elements of metabolic syndrome and deceased donor
(6) Steroid withdrawal a few days after transplantation resulted in less PTDM only in patients receiving cyclosporine compared to tacrolimus.(7) The new agent belatacept is not associated with increased risk of PTDM when compared to cyclosporine.(8)
Summary
Post-transplant diabetes mellitus is a major complication after transplantation and is associated with reduced allograft and patient survival.(1) It is hard to quantify the incidence of PTDM because of lack of standard definition and PTDM can occur many years after transplantation. A consensus conference in 2013, defined PTDM as newly diagnosed persistent diabetes mellitus among clinically stable posttransplant patients.(2) Multiple risk factors contribute to the development of diabetes after transplantation including: immunosuppressive agents (steroids and CNIs the risk is greater with tacrolimus), age (incidence after age 40), family history, other elements of metabolic syndrome (hypertriglyceridemia, hypertension and hyperuricemia) and deceased donor.
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