Post-transplant diabetes mellitus: risk factors, frequency of transplant rejections, and long-term prognosis

Schiel, Ralf; Heinrich, Sebastian; Steiner, Thomas; Ott, U.; Stein, Günter

doi:10.1007/s10157-005-0346-y

Cited by 23 publications

(19 citation statements)

References 28 publications

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“…In the present study, we found glucocorticoid-induced DM in 17 (40%) of the 42 patients who underwent glucocorticoid therapy for their renal diseases. As previously reported [6,7,8], an older age and obesity were also determined to be independent risk factors for development of DM during glucocorticoid therapy.…”

Section: Discussionmentioning

confidence: 51%

“…Panthakalam et al [3] reviewed 102 patients with rheumatoid arthritis who were on corticosteroids for a median duration of 24 months and found 9 patients (8.8%) who developed DM during treatment. In addition, the prevalence of new-onset DM after renal transplantation was reported to be 17% [6]. Although patients with primary renal diseases were usually treated with higher doses of corticosteroids than those with rheumatoid arthritis, the prevalence of glucocorticoid-induced hyperglycemia is not known.…”

Section: Discussionmentioning

confidence: 99%

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Glucocorticoid-Induced Diabetes Mellitus: Prevalence and Risk Factors in Primary Renal Diseases

et al. 2006

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Background/Aims: In patients with primary renal diseases the current knowledge of hyperglycemia associated with corticosteroid therapy is limited. We therefore examined the prevalence and risk factors of glucocorticoid-induced diabetes mellitus (DM) in primary renal diseases. Methods: Patients were recruited with primary renal diseases who were started on corticosteroids between April 2002 and June 2005. In patients with DM, an impaired fasting glucose level and/or positive urinary glucose analyses before corticosteroids therapy were excluded. Results: During corticosteroid therapy (initial dose: prednisolone 0.75 ± 0.10 mg/kg/day), DM was newly diagnosed in 17 (40.5%) of 42 patients. All of the 17 patients were diagnosed as having DM by postprandial hyperglycemia at 2 h after lunch, although they had normal fasting blood glucose levels. Age (OR 1.40, 95% CI 1.06–1.84) and body mass index (OR 1.87, 95% CI 1.03–3.38) were determined as independent risk factors for glucocorticoid-induced DM. Conclusion: Over 40% of patients with primary renal disease developed DM during treatment with corticosteroids. A high age and high body mass index are the independent risk factors for glucocorticoid-induced DM. 24-hour urinary glucose analyses and postprandial plasma glucose are useful for detecting glucocorticoid-induced DM.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Glucocorticoid-Induced Diabetes Mellitus: Prevalence and Risk Factors in Primary Renal Diseases

et al. 2006

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“…Posttransplant diabetes mellitus is a major problem in longterm transplant recipients and is mainly related to side effects of immunosuppressive therapy such as steroids and tacrolimus [31,32]. Other risk factors are abnormal high body mass index at the time of transplantation and higher age [31].…”

Section: Posttransplant Diabetes Mellitusmentioning

confidence: 99%

Renal transplantation today

Neipp

Jackobs

Klempnauer

2008

Langenbecks Arch Surg

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“…Prevalence of NODAT has been reported at 17% [5]. Therefore, several groups have studied pre-transplant factors of interest to predict future NODAT.…”

Section: Introductionmentioning

confidence: 99%

Predictors of New Onset of Diabetes after Transplantation in Stable Renal Recipients

Shehab-Eldin

Shoker

2008

Nephron Clin Pract

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Background: Several groups identified pre-transplant factors which contribute to the development of new onset of diabetes after transplantation (NODAT). Aim: To identify post-transplant risk factors for NODAT. Methods: 55 stable renal transplant patients were divided into group A of 34 recipients with normoglycemia and group B of 21 recipients with impaired fasting glucose. Markers including insulin, pro-insulin, soluble receptors for advanced glycated end products (sRAGE), adiponectin, malondialdehyde, homeostasis model assessment of insulin resistance (HOMA-IR), and β-cell function were calculated at the outset and correlated, thereafter, with the later development of NODAT after a follow-up duration of 14.98 ± 3.97 months. Results: 11.8 and 19% of groups A and B respectively developed NODAT. Insulin, sRAGE, HOMA-IR and basal fasting plasma glucose correlated with the development of NODAT in univariate analysis. A baseline insulin level of 54.54 mU/l predicted the development of NODAT with a specificity of 95.45% and was the only significant factor in the multivariate analysis. β-Cell function was not different among the three groups. Conclusions: A long prodrome of insulin resistance (IR) exists prior to development of NODAT. 50% of patients with NODAT will remit to a normoglycemic state. IR, rather than β-cell dysfunction, precedes the development of NODAT. Serum insulin in stable non-diabetic renal transplant patients can be used as a confirmatory test to the development of future NODAT.

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Post-transplant diabetes mellitus: risk factors, frequency of transplant rejections, and long-term prognosis

Cited by 23 publications

References 28 publications

Glucocorticoid-Induced Diabetes Mellitus: Prevalence and Risk Factors in Primary Renal Diseases

Glucocorticoid-Induced Diabetes Mellitus: Prevalence and Risk Factors in Primary Renal Diseases

Renal transplantation today

Predictors of New Onset of Diabetes after Transplantation in Stable Renal Recipients

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