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Published on: May 5, 2018
Transplant-associated hyperglycemia: a new look at an old problem
Michael F Crutchlow1, Roy D Bloom
1Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Clinical Journal of the American Society of Nephrology : CJASN
|August 21, 2007
Summary
Transplant-associated hyperglycemia (TAH), including new-onset diabetes and prediabetes, is a significant complication after kidney transplants. Early detection through screening and interventions like lifestyle changes can mitigate its severe impact on patient health and graft survival.
Area of Science:
- Nephrology
- Endocrinology
- Transplantation Medicine
Background:
- New-onset diabetes is a common kidney transplant complication, increasing cardiovascular disease, mortality, and graft failure.
- Prediabetic states like impaired fasting glucose and impaired glucose tolerance are highly prevalent post-transplant, negatively impacting cardiovascular health.
- Transplant-associated hyperglycemia (TAH) encompasses both diabetes and prediabetes, presenting a greater burden than previously understood.
Purpose of the Study:
- To highlight the significant impact of transplant-associated hyperglycemia (TAH) in kidney transplant recipients.
- To emphasize the combined risks of TAH, metabolic syndrome, and atherosclerosis in this population.
- To underscore the importance of screening, risk factor modification, and therapeutic interventions for TAH.
Main Methods:
- Review of recent studies on post-transplantation hyperglycemia and its complications.
- Analysis of the predisposition of kidney transplant recipients to insulin resistance and metabolic syndrome.
- Identification of transplant-specific diabetogenic exposures contributing to TAH.
Main Results:
- TAH, including prediabetes, is highly prevalent and significantly impacts cardiovascular health.
- Kidney transplant recipients have inherent risks for glucose dysregulation, exacerbated by transplant-related factors.
- Aggressive screening is effective in detecting TAH, while interventions can reduce its adverse effects.
Conclusions:
- The overall burden of TAH is substantial and underestimated.
- Management strategies including screening, lifestyle changes, and pharmacotherapy are crucial for mitigating TAH.
- Future research should explore novel diabetes therapies for TAH prevention and reversal.
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