New-onset diabetes mellitus after solid organ transplantation

Transpl Int. 2009 May;22(5):519-30. doi: 10.1111/j.1432-2277.2008.00800.x. Epub 2008 Nov 20.

Abstract

New-onset diabetes mellitus is a common complication of solid organ transplantation and is likely to become even more common with the current epidemic of obesity in some countries. It has become clear that both new-onset diabetes and prediabetic states (impaired fasting glucose and impaired glucose tolerance) negatively influence graft and patient survival after transplantation. This observation forms the basis for recommending meticulous screening for glucose intolerance before and after transplantation. Although a number of clinical factors including age, weight, ethnicity, family history, and infection with hepatitis C are closely associated with the new-onset diabetes mellitus, immunosuppression with corticosteroids, calcineurin inhibitors and possibly sirolimus plays a dominant role in its pathogenesis. Management of new-onset diabetes after transplantation generally conforms to the guidelines for treatment of type 2 diabetes mellitus in the general population. However, further studies are needed to determine the optimal immunosuppressive regimens for patients with this disorder.

Publication types

  • Review

MeSH terms

  • Blood Glucose / analysis
  • Diabetes Mellitus / etiology*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Heart Transplantation / adverse effects
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Immunosuppression / adverse effects
  • Immunosuppressive Agents / adverse effects
  • Insulin / therapeutic use
  • Kidney Transplantation / adverse effects
  • Liver Transplantation / adverse effects
  • Obesity / complications
  • Organ Transplantation / adverse effects*
  • Risk Factors

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Immunosuppressive Agents
  • Insulin