Renal transplantationComplications: MetabolicRisk Factors for the Development of New-Onset Diabetes Mellitus in a Living Related Renal Transplant Program
Section snippets
Materials and Methods
We examined 78 adult end-stage renal disease patients due to all causes except diabetic nephropathy, who were on the waiting list for a first live related renal transplantation. Our primary aim of the study was to correlate the incidence of NODM with pretransplant glycemic profiles, fasting plasma C-peptide levels, plasma insulin levels, and pretransplant insulin resistance. An oral glucose tolerance test (OGTT) was performed both pre as well as 1, 3, 6 and 12 months posttransplantation.
Results
The mean age of study recipients was 32.4 years, including 65.4% below and 34.6% above 40 years of age. There were 65 males and 13 female recipients (M:F = 5:1). Sixteen patients (20.4%) were hepatitis C virus (HCV) positive before transplantation. The most common blood groups were group B (41%) and group O (26.9%) with group A (17.9%) and group AB (14.1%) constituting the other cases.
The mean age of the living donors was 43.03 years, including 37.2% below and 62.8% above 40 years of age. Most
Discussion
The development of NODM is a well-known complication in renal transplant patients with an incidences of 2% to 50% reported in various studies.3, 4, 5 Most patients develop NODM within the early postoperative months.5 In the present study, we observed an NODM incidence of 16.7% using the ADA criteria,7 a figure that is consistent with the literature.5 A previous study from our institute by Saxena et al8 performed between 1978 and 1992 reported a much lower (4.8%) incidence of NODM. However,
References (12)
- et al.
Post-transplant diabetes mellitus: increasing incidence in renal allograft recipients transplanted in recent years
Kidney lnt
(2001) - et al.
Diabetes mellitus after kidney transplantation in the United States
Am J Transplant
(2003) - et al.
Emerging issues in hepatitis C virus-positive liver and kidney transplant recipients
Am J Transplant
(2006) - et al.
Post-transplant diabetes mellitus in pediatric liver transplantation
Pediatr Transplant
(2009) - et al.
Post-transplant diabetes mellitus in lung transplant recipients: incidence and risk factors
Eur J Cardiothorac Surg
(2008) - et al.
Post-transplantation diabetes: a systematic review of the literature
Diabetes Care
(2002)
Cited by (10)
An observational prospective study to evaluate the outcomes of new onset diabetes after renal transplantation (NODAT) in a tertiary care centre in eastern India
2020, Diabetes Research and Clinical PracticeCitation Excerpt :In a study conducted by Valderhaug TG et al., post-transplant diabetes mellitus (PTDM) was reported in 14% patients [16]. In Indian studies, the incidences of NODAT were 19.12%, 16.75% and 54.5% in studies conducted by Prakash J et al., Sharma A et al., and Bora GS et al respectively [17–19]. So there has been wide variation among incidence and in our study, the incidence of NODAT is 24%.
A novel mechanism of pre-transplant insulin resistance contributing to post-transplant complications: Cyclosporin A-induced O-GlcNAcylation
2017, Biochemical and Biophysical Research CommunicationsCitation Excerpt :Tokodai et al. demonstrate that insulin resistance, as judged by homeostasis model assessment for insulin resistance (HOMA-IR), acts as a risk factor for new-onset diabetes after transplantation (NODAT) [4]. Moreover, several clinical studies also show that pre-transplant glucose intolerance is an independent predictor of NODAT [5–8]. However, the underlying mechanism behind this is less investigated.
The incidence of new onset diabetes after transplantation and related factors: Single center experience
2017, NefrologiaCitation Excerpt :This suggests that diabetogenic effect of tacrolimus is dose dependent.49 However, in some studies, authors did not observe any association between tacrolimus and PTDM.50,51 In our study, there was no significant difference between tacrolimus and cyclosporine.
Post-transplant diabetes mellitus: Is it associated with poor allograft outcomes in renal transplants?
2013, Transplantation ProceedingsCitation Excerpt :The incidence of infection, acute rejection, and delayed graft function were related to the intensity and type of immunosuppressant used. Tacrolimus was more diabetogenic than CsA, and, in the ELITE (Efficacy Limiting Toxicity Elimination)- Symphony study in which a similar mycophenolate mofetil dose was administered in combination with standard or low doses of calcineurin inhibitors (CsA and tacrolimus), bacterial and viral infections were more common with the standard dose of cyclosporine.21 In our study, the levels of tadrolimus and CsA used were above their therapeutic ranges.
Post-transplant Diabetes Mellitus: What Physicians Need to Know
2022, Journal of Association of Physicians of IndiaAn observational prospective study to evaluate the preoperative risk factors of new-onset diabetes mellitus after renal transplantation in a tertiary care centre in Eastern India
2018, Indian Journal of Endocrinology and Metabolism