Authors: Joran Hjelmesaeth; Anders Asberg; Fredrik Muller; Anders Hartmann; Trond Jenssen

Source: Current Diabetes Reviews, Volume 1, Number 1, January 2005 , pp. 1-10(10)

Publisher: Bentham Science Publishers

Abstract:

Restoration of renal function may ameliorate uremia induced insulin resistance. Therefore it seems a paradox that new-onset posttransplantation diabetes mellitus (PTDM) is a frequently observed complication after renal transplantation. The incidence varies between 2 and 50% depending on the population under study, criteria for the diagnosis of diabetes and the time of follow up.

This review addresses recent findings on transplant specific risk factors and pathogenesis of PTDM after solid organ transplantation, and we focus on the following issues:

1. The relative impact of insulin resistance and insulinopenia in the pathogenesis of PTDM.

2. The role of immunosuppressive drugs with special emphasis on calcineurin inhibitors (cyclosporine A, tacrolimus) and steroids. 3. The possible roles of cytomegalovirus and hepatitis C infections. Conclusions: New-onset PTDM is characterized by a variety of clinical manifestations, ranging from predominantly insulin resistance which can be handled with lifestyle intervention, to -cell failure requiring insulin treatment. The etiology is multi-factorial, but diabetogenic immunosuppressive drugs are of major importance. Future studies should therefore address the effects of different immunosuppressive regimens on the incidence of PTDM. In addition, the impact of cytomegalovirus infection and hepatitis C on PTDM needs further evaluation.

Keywords: diabetes mellitus; transplantation; insulin; immunosuppression; steroids; virus infection

Document Type: Review article

DOI: http://dx.doi.org/10.2174/1573399052952604

Affiliations: 1: Department of Medicine, The Hospital in Vestfold HF, Boks 2168, 3103 Tonsberg, Norway.

Publication date: 2005-01-01

More about this publication?

• Current Diabetes Reviews publishes frontier reviews on all the latest advances on diabetes and its related areas e.g. pharmacology, pathogenesis, complications, epidemiology, clinical care, and therapy.
  
  The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians who are involved in the field of diabetes.

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