New Onset Diabetes After Transplantation (NODAT) — scientific data review

Zielińska, K; Kukulski, Leszek; Wróbel, Marta; Przybyłowski, Piotr; Zielińska, Marta; Strojek, Krzysztof

doi:10.5603/dk.2020.0047

Cited by 2 publications

(1 citation statement)

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“…Among immunosuppressive drugs used in solid organ transplantation protocols, tacrolimus is characterized by the strongest diabetogenic effects [ 24 ]. In the present study, patients with abnormal glycemic state had significantly elevated trough tacrolimus levels at 6 months ( p = 0.03).…”

Section: Discussionmentioning

confidence: 99%

Monitoring of blood glucose after pediatric kidney transplantation: a longitudinal cohort study

Salah

Hafez

Selem³

et al. 2022

Pediatr Nephrol

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Background Glucose metabolism after kidney transplantation (KT) is highly dynamic with the first post-transplantation year being the most critical period for new-onset diabetes after transplantation (NODAT) occurrence. The present study aimed to analyze dynamics of glucose metabolism and report incidence/risk factors of abnormal glycemic state during the first year after KT in children. Methods Twenty-one consecutive freshly transplanted pediatric kidney transplant recipients (KTRs) were assessed for fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) weekly for 4 weeks, then every 3 months for 1 year. Results Interpretation of OGTT test showed normal glucose tolerance (NGT) in 6 patients (28.6%) while 15 (71.4%) experienced impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) at any time point of monitoring. Seven patients had NODAT, for which three needed insulin therapy. Hyperglycemia onset was 7.8 ± 13.12 weeks (median (range) = 1 (0–24) week) after KT. Percent of patients with abnormal OGTT was significantly more than that of IFG (38.1% vs. 71.4%, p = 0.029). Patients with abnormal glycemic state had significantly elevated trough tacrolimus levels at 6 months (p = 0.03). Glucose readings did not correlate with steroid doses nor rejection episodes while positively correlating with tacrolimus doses at 3 months (p = 0.02, CC = 0.73) and 6 months (p = 0.01, CC = 0.63), and negatively correlating with simultaneous GFR at 9 months (p = 0.04, CC = − 0.57). Conclusions Up to two thirds of pediatric KTRs (71.4%) experienced abnormal glycemic state at some point with peak incidence within the first week up to 6 months after KT. OGTT was a better tool for monitoring of glucose metabolism than FPG. Abnormal glycemic state was induced by tacrolimus and adversely affected graft function. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information.

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Section: Discussionmentioning

confidence: 99%