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Management of Post-Transplant Diabetes

  • Hospital Management of Diabetes (G Umpierrez, Section Editor)
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Abstract

New onset diabetes mellitus after transplant (NODAT) refers to the development of diabetes post-transplant in previously non-diabetic patients and is associated with increased rates of acute transplant rejection, infection, late cardiovascular events, and decreased survival. NODAT is primarily due to the immunosuppressive drug regimen but the standard predisposing risk factors for diabetes also pertain. NODAT is diagnosed by the standard ADA criteria, once prednisone doses are less than 10 mg per day and in the absence of acute illness. Sulfonylureas, metformin, DPP-4 inhibitors, GLP-1 agonists, and insulin can be used in treatment, but when there is impaired kidney or hepatic function, special precautions are necessary. In addition, those drugs interacting with P450 enzymes require additional consideration because of possible interaction with immunosuppressive drug metabolism.

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Disclosure

Conflicts of interest: A. Therasse: none; A. Wallia: none; M.E. Molitch: has been a consultant, and member DSMB of Abbott Laboratories, and has been a consultant for Novartis, Corcept; has given expert testimony for Janssen on Risperdal; has received grant support from Sanofi-Aventis for an investigator-initiated study, from ENDO for studies of acromegaly, from Ipsen for studies of acromegaly, from Corcept for studies of Cushing’s syndrome, and from Novartis for studies of Cushing’s syndrome;

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  1. Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 530, Chicago, IL, 60611, USA

    Ashley Therasse, Amisha Wallia & Mark E. Molitch

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  1. Ashley Therasse
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  2. Amisha Wallia
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Correspondence to Amisha Wallia.

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Therasse, A., Wallia, A. & Molitch, M.E. Management of Post-Transplant Diabetes. Curr Diab Rep 13, 121–129 (2013). https://doi.org/10.1007/s11892-012-0346-8

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