Post-transplantation diabetes mellitus: evaluation of treatment strategies

Clinical Transplantation
Michael HaidingerJohannes Werzowa

Abstract

Post-transplantation diabetes mellitus (PTDM) is a serious complication after kidney transplantation, but evidence regarding long-term outcomes of treatment regimens remains scarce. The aim of this retrospective cohort analysis was to assess the long-term efficiency and safety of antidiabetic treatments in kidney transplant recipients (KTRs), who were diagnosed with PTDM by an oral glucose tolerance test (OGTT). Of 561 KTRs that were screened for PTDM at our outpatient clinic, 71 (13%) had a diabetic OGTT and were included in this study. Mean follow-up was 34.2 ± 16.1 months. Thirty-six PTDM patients (51%) received antidiabetic treatment after diagnosis with either a dipeptidyl peptidase-4 (DPP-4) inhibitor, a sulfonylurea, pioglitazone, or insulin. These patients had significantly higher fasting glucose and two-h plasma glucose (2HPG) values at baseline than those who remained without therapy. In contrast to lifestyle modification alone or sulfonylureas, DPP-4 inhibitors improved glycemic control significantly. Adverse events were generally mild and occurred at similar rates in all groups. While sulfonylureas failed to improve glycemic control, DPP-4 inhibitors appeared effective and safe for the therapy of PTDM after kidney t...Continue Reading

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Citations

Sep 15, 2015·Clinica Chimica Acta; International Journal of Clinical Chemistry·Ana Laura PimentelJoíza Lins Camargo
Dec 10, 2015·Endocrine Reviews·Vijay ShivaswamyJennifer Larsen
Apr 7, 2018·Journal of Transplantation·Matthew G CehicPeter S Macdonald
Feb 26, 2020·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Syed Haris AhmedShazli Azmi
Jul 3, 2021·Journal of Clinical Medicine·Paloma Leticia Martin-MorenoAnil Chandraker

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