Comparing Glycaemic Benefits of Active Versus Passive Lifestyle Intervention in Kidney Allograft Recipients: A Randomized Controlled Trial

Kuningas, Kulli; Driscoll, Joanne; Mair, Reena; Smith, Helen; Dutton, Mary Ann; Day, Ed; Sharif, And Adnan

doi:10.1097/tp.0000000000002969

Cited by 40 publications

(52 citation statements)

References 32 publications

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“…In support of this concept, central obesity rather than body mass index is associated with development of PTDM [91]. A randomized controlled trial (CAVIAR) comparing active versus passive lifestyle intervention postkidney transplantation [92] demonstrated improvements in secondary clinical endpoints including weight loss, reduced fat mass, and a suggestion of reduced PTDM incidence (7.6% versus 15.6% respectively, P = 0.123). A multi‐center study with reduction in PTDM as the primary outcome is being planned, powered by the empirical data obtained from the CAVIAR study.…”

Section: Management Of Ptdm: Early Prevention—lifestyle and Early Insmentioning

confidence: 99%

Management of post‐transplant diabetes: immunosuppression, early prevention, and novel antidiabetics

et al. 2020

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Summary Post‐transplant diabetes mellitus (PTDM) shows a relationship with risk factors including obesity and tacrolimus‐based immunosuppression, which decreases pancreatic insulin secretion. Several of the sodium–glucose‐linked transporter 2 inhibitors (SGLT2is) and glucagon‐like peptide 1 receptor agonists (GLP1‐RAs) dramatically improve outcomes of individuals with type 2 diabetes with and without chronic kidney disease, which is, as heart failure and atherosclerotic cardiovascular disease, differentially affected by both drug classes (presumably). Here, we discuss SGLT2is and GLP1‐RAs in context with other PTDM management strategies, including modification of immunosuppression, active lifestyle intervention, and early postoperative insulin administration. We also review recent studies with SGLT2is in PTDM, reporting their safety and antihyperglycemic efficacy, which is moderate to low, depending on kidney function. Finally, we reference retrospective case reports with GLP1‐RAs that have not brought forth major concerns, likely indicating that GLP1‐RAs are ideal for PTDM patients suffering from obesity. Although our article encompasses PTDM after solid organ transplantation in general, data from kidney transplant recipients constitute the largest proportion. The PTDM research community still requires data that treating and preventing PTDM will improve clinical conditions beyond hyperglycemia. We therefore suggest that it is time to collaborate, in testing novel antidiabetics among patients of all transplant disciplines.

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Section: Management Of Ptdm: Early Prevention—lifestyle and Early Insmentioning

confidence: 99%

Management of post‐transplant diabetes: immunosuppression, early prevention, and novel antidiabetics

et al. 2020

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“…Tzvetanov et al (2014) showed no significant between-group difference in body mass index (BMI) when comparing 12 months of exercise and nutrition counselling to usual care in obese KTRs. A RCT compared the effects of 6 months of face-to-face nutrition counselling and physical activity by a renal dietician, to usual care on insulin sensitivity in new KTRs (Kuningas et al, 2019). Whilst there was no change in insulin sensitivity, the authors reported a significant mean between-group difference in body weight over the 6-month study (À2.47 kg [À4.01 to À0.92]; Kuningas et al, 2019).…”

Section: Weight Gain Prevention Interventionsmentioning

confidence: 99%

Usability and experience testing to refine an online intervention to prevent weight gain in new kidney transplant recipients

Castle

Greenwood

Chilcot

et al. 2020

British J Health Psychol

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Objectives. Weight gain in the first year following kidney transplantation increases the risk of adverse health outcomes. Currently, there is no recognized intervention available to prevent weight gain after kidney transplantation. An online kidney transplant-specific resource, entitled Exercise in Renal Transplant Online (ExeRTiOn), has been co-created by a multi-professional team, including patients, to assist with weight prevention. This study aimed to evaluate patient and health care professional usability and experience of the ExeRTiOn online resource. Design. Qualitative study utilizing 'Think-Aloud' and semi-structured interviews. Methods. Participants (n = 17) were purposively sampled to include new kidney transplant recipients (n = 11) and transplant health care professionals (n = 6). Kidney transplant recipient participants were from a spread of physical activity levels based on scores from the General Practice Physical Activity Questionnaire (GPPAQ). 'Think-Aloud' interviews assessed the usability of ExeRTiOn. Semi-structured interviews explored participants' experience of ExeRTiOn, weight gain, and physical activity. The data set were analysed thematically. Participant characteristics, including login data and self-reported body weight, were collected. Results. Data analyses identified valued intervention content and usability aspects which were summarized by two themes. The first theme 'You need to know how to manage yourself' included subthemes: (1) the resource filled a guidance gap, (2) expert patient content resonated, and (3) the importance of goal setting and monitoring progress. The second theme 'room for improvement' included subthemes: (2) web support and (2) content and operational change suggestions.

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“…Detailed discussion on the management of NODAT is beyond the scope of this article but it broadly involves both lifestyle modification and pharmacological therapy with oral hypoglycaemic agents or insulin therapy. Strategies similar to those for non‐transplant patients with type 2 diabetes such as personalised dietary advice and graded exercise programmes can be adopted in NODAT, although there is no evidence to support that this results in improvement in surrogate markers of glucose metabolism 84 …”

Section: New Onset Diabetes After Transplantationmentioning

confidence: 99%

Diabetic kidney disease and transplantation options

2021

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Diabetes is the leading cause of chronic kidney disease worldwide and associated with significant morbidity and mortality. Despite advances in treatment options for diabetic kidney disease, a substantial proportion of patients still progress to end‐stage renal disease. While not without its own risk and complications, transplantation remains the best modality of renal replacement therapy in terms of patient outcome and cost‐effectiveness when compared to dialysis. This article reviews diabetic kidney disease with a focus on options for transplantation including kidney, pancreas and islet cell transplantation. Copyright © 2021 John Wiley & Sons.

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Comparing Glycaemic Benefits of Active Versus Passive Lifestyle Intervention in Kidney Allograft Recipients: A Randomized Controlled Trial

Abstract: Comparing glycaemic benefits of active versus passive lifestyle intervention in kidney allograft recipients (CAVIAR): a randomised controlled trial', Transplantation.

Cited by 40 publications

References 32 publications

Management of post‐transplant diabetes: immunosuppression, early prevention, and novel antidiabetics

Management of post‐transplant diabetes: immunosuppression, early prevention, and novel antidiabetics

Usability and experience testing to refine an online intervention to prevent weight gain in new kidney transplant recipients

Diabetic kidney disease and transplantation options

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