Post-Transplantation Diabetes Mellitus.
Syed Haris AhmedKathryn BiddleTitus AugustineShazli AzmiPublished in: Diabetes therapy : research, treatment and education of diabetes and related disorders (2020)
Solid organ transplantation (SOT) is an established therapeutic option for chronic disease resulting from end-stage organ dysfunction. Long-term use of immunosuppression is associated with post-transplantation diabetes mellitus (PTDM), placing patients at increased risk of infections, cardiovascular disease and mortality. The incidence rates for PTDM have varied from 10 to 40% between different studies. Diagnostic criteria have evolved over the years, as a greater understating of PTDM has been reached. There are differences in pathophysiology and clinical course of type 2 diabetes and PTDM. Hence, managing this condition can be a challenge for a diabetes physician, as there are several factors to consider when tailoring therapy for post-transplant patients to achieve better glycaemic as well as long-term transplant outcomes. This article is a detailed review of PTDM, examining the pathogenesis, diagnostic criteria and management in light of the current evidence. The therapeutic options are discussed in the context of their safety and potential drug-drug interactions with immunosuppressive agents.
Keyphrases
- cardiovascular disease
- type diabetes
- glycemic control
- end stage renal disease
- ejection fraction
- cell therapy
- cardiovascular events
- newly diagnosed
- emergency department
- risk factors
- primary care
- prognostic factors
- stem cells
- peritoneal dialysis
- oxidative stress
- coronary artery disease
- adipose tissue
- risk assessment
- bone marrow
- patient reported
- cardiovascular risk factors
- electronic health record