Diabetes mellitus following paediatric renal transplantation: a single centre experience

Area of Science:

• Pediatric Nephrology
• Endocrinology
• Transplantation Immunology

Background:

• Post-transplant diabetes mellitus (PTDM) affects 4-41% of pediatric and adult transplant recipients.
• PTDM presents with variable incidence and clinical manifestations.
• This study focuses on the experience of PTDM in a pediatric renal transplantation center.

Purpose of the Study:

• To describe the incidence and clinical characteristics of PTDM in pediatric renal transplant recipients.
• To analyze the management and outcomes of PTDM in children.
• To emphasize the importance of early recognition and intervention for PTDM.

Main Methods:

• Retrospective analysis of glycaemic status in pediatric renal transplant patients over a 2-year period.
• Detailed review of clinical features and investigations in patients who developed PTDM.
• Assessment of PTDM's impact on renal graft function.

Main Results:

• Five episodes of PTDM occurred in 4 out of 32 pediatric patients.
• PTDM onset and symptoms were variable, with findings of insulinopenia and peripheral insulin resistance.
• Insulin therapy led to PTDM resolution in four episodes, with no adverse effect on renal graft function.

Conclusions:

• PTDM requires heightened awareness among pediatric nephrologists and endocrinologists.
• Early recognition and prompt, effective intervention are crucial for managing PTDM in children.
• PTDM management should be integrated into post-transplant care protocols.