New-onset diabetes mellitus in a previously non-diabetic transplant recipient is a serious adverse event that confers significant morbidity and mortality. The most significant consequences of post-transplant diabetes mellitus (PTDM) in solid organ transplant recipients include decreased patient and graft survival, an increased risk of infectious complications, and morbid cardiovascular events. The development of PTDM in the elderly is of particular concern because this group is already at increased risk of progression of cardiovascular disease. Because the elderly, especially those aged >65 years, are the fastest-growing segment of the renal transplant population, attention needs to be given to PTDM risk reduction and post-transplant management. PTDM develops as a consequence of both impaired insulin production and enhanced peripheral insulin resistance. A number of non-modifiable factors such as age, race, family history, hepatitis C, polycystic kidney disease and emerging genetic causes have been identified as risk factors for PTDM. However, a number of modifiable factors can be targets for intervention in high-risk patients, including bodyweight (through dietary restriction and exercise), hypertension, hyperlipidaemia and th...Continue Reading
Mechanisms of action of cyclosporin A on islet alpha- and beta-cells. Effects on cAMP- and calcium-dependent pathways
The impact of cyclosporine and combination immunosuppression on the incidence of posttransplant diabetes in renal allograft recipients
Transcriptional inhibition of insulin by FK506 and possible involvement of FK506 binding protein-12 in pancreatic beta-cell
Age-related alteration of pancreatic beta-cell function. Increased proinsulin and proinsulin-to-insulin molar ratio in elderly, but not in obese, subjects without glucose intolerance
Impaired cAMP-mediated gene expression and decreased cAMP response element binding protein in senescent cells
Abnormal effect of thiol groups on erythrocyte Na/Li countertransport kinetics in adult polycystic kidney disease
Erythrocyte membrane fluidity in adult polycystic kidney disease: difference between intact cells and ghost membranes
Gene-specific transcriptional activity of the insulin cAMP-responsive element is conferred by NF-Y in combination with cAMP response element-binding protein.
Inhibition of cyclic AMP response element-binding protein/cyclic AMP response element-mediated transcription by the immunosuppressive drugs cyclosporin A and FK506 depends on the promoter context
The effects of maintenance doses of FK506 versus cyclosporin A on glucose and lipid metabolism after orthotopic liver transplantation
Identification of glucokinase mutation in subjects with post-renal transplantation diabetes mellitus
Post-transplant diabetes mellitus: increasing incidence in renal allograft recipients transplanted in recent years
Influence of diabetes mellitus on patient and graft survival in recipients of kidney transplantation
beta-Cell dysfunction rather than insulin resistance is the main contributing factor for the development of postrenal transplantation diabetes mellitus
Regulation of insulin gene transcription by a Ca(2+)-responsive pathway involving calcineurin and nuclear factor of activated T cells
NFAT regulates insulin gene promoter activity in response to synergistic pathways induced by glucose and glucagon-like peptide-1
Efficacy and safety of tacrolimus compared with ciclosporin microemulsion in renal transplantation: a randomised multicentre study
Outcomes of African American kidney transplant recipients treated with sirolimus, tacrolimus, and corticosteroids
Kidney transplantation without calcineurin inhibitor drugs: a prospective, randomized trial of sirolimus versus cyclosporine
Diabetes mellitus after transplant: relationship to pretransplant glucose metabolism and tacrolimus or cyclosporine A-based therapy
Development of diabetes mellitus post-renal transplantation is associated with poor short-term clinical outcomes
New onset diabetes mellitus in patients receiving calcineurin inhibitors: a systematic review and meta-analysis
Comparison of sirolimus-based calcineurin inhibitor-sparing and calcineurin inhibitor-free regimens in cadaveric renal transplantation
New onset diabetes after kidney transplantation in autosomal dominant polycystic kidney disease: a retrospective cohort study
Oral administration of ginseng ameliorates cyclosporine-induced pancreatic injury in an experimental mouse model
Role of alpha-lipoic acid in ameliorating Cyclosporine A-induced pancreatic injury in albino rats: A structural, ultrastructural, and morphometric study
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