New onset diabetes and impaired fasting glucose after liver transplant: risk analysis and the impact of tacrolimus dose

Exp Clin Transplant. 2014 Feb;12(1):46-51. doi: 10.6002/ect.2013.0047. Epub 2013 Jul 30.

Abstract

Objectives: New onset diabetes mellitus after transplant is one of the major metabolic complications after liver transplant. Development of impaired fasting glucose after liver transplant is thought to be associated with increased risk of cardiovascular mortality and has not been well studied before. The aim of this study was to evaluate incidence and risk factors of new onset diabetes mellitus after transplant and impaired fasting glucose in liver transplant patients.

Materials and methods: In a cross-sectional study, all adult patients (aged≥18 years) who were transplanted because of chronic liver diseases from June 2002 to September 2010 at Shiraz Liver Transplant Center were evaluated for developing diabetes and impaired fasting glucose.

Results: Totally, 86 patients (18.81%) were found to have diabetes after liver transplant. Forty patients (27 men and 13 women; 8.75%) developed new onset diabetes mellitus after transplant and 36 patients (7.87%) developed impaired fasting glucose after liver transplant. The mean age of patients with new onset diabetes mellitus after transplant was higher than that of nondiabetic patients (P = .001). Mean fasting plasma glucose before liver transplant was significantly higher in diabetic patients compared with nondiabetic patients (P = .002) (5.20±0.93 mmol/L vs 4.44±0.56 mmol/L) (93.86±16.80 mg/dL vs 80±10.14 mg/dL). Patients with new onset diabetes mellitus after transplant received higher doses of tacrolimus as immunosuppressive medication than nondiabetic patients (P = .001).

Conclusions: Fasting plasma glucose before transplant can predict development of new onset diabetes mellitus after transplant. Age and tacrolimus dosage are independent risk factors for new onset diabetes mellitus after transplant in our patients.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Glucose / drug effects*
  • Blood Glucose / metabolism
  • Cross-Sectional Studies
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / chemically induced
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology*
  • Fasting / blood*
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects*
  • Incidence
  • Iran / epidemiology
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Tacrolimus / administration & dosage
  • Tacrolimus / adverse effects*
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Immunosuppressive Agents
  • Tacrolimus