title: Reduced incidence of new-onset posttransplantation diabetes mellitus during the last decade.
abstract: BACKGROUND
  A previous study (1995-1996) of 173 nondiabetic renal transplant recipients (historical cohort; HC) revealed a 20% incidence of new-onset posttransplantation diabetes mellitus (PTDM) and 32% with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). We examined whether glucose tolerance has improved after recent changes in our immunosuppressive protocol and a switch from deferred to preemptive cytomegalovirus (CMV) therapy.
  
  
  METHODS
  A total of 321 consecutive, nondiabetic patients (new cohort; NC) were examined 10 weeks after kidney transplantation with an oral glucose tolerance test (n=301) between January 2004 and December 2005.
  
  
  RESULTS
  Although recipients in the NC were on average 3 years older [mean (SD): 50.3 (14.6) vs. 47.4 (16.0), P=0.038] and had a higher mean body mass index [24.5 (3.6) vs. 23.5 (3.8) kg/m(2), P=0.003], a significantly lower incidence of both PTDM (13%) and IGT/IFG (18%) was observed in the NC (P<0.001) as compared to the HC. The patients in the NC received a significantly lower mean daily oral prednisolone dose [13.2 (4.7) vs. 15.3 (6.6) mg/day, P<0.001], and had lower frequencies of rejections (36% vs. 57%, P<0.001) and CMV infection (54% vs. 63%, P=0.071). Patients in the NC had significantly lower odds of developing PTDM, even after adjustment for age, prednisolone dose, HLA-B27 status and CMV infection (odds ratio: 0.42, 95% CI: 0.23-0.77, P=0.005).
  
  
  CONCLUSIONS
  The odds of developing PTDM are more than halved over the last decade. Possible explanations are changes in immunosuppressive therapy, fewer rejections, and lower doses of steroids.
authors.affiliation: Medical Department, Rikshospitalet, University of Oslo, Norway. tone.gretland@netcom.no
authors.forename: Tone Gretland
authors.initials: TG
authors.lastname: Valderhaug
authors.forename: Jøran
authors.initials: J
authors.lastname: Hjelmesaeth
authors.forename: Halvor
authors.initials: H
authors.lastname: Rollag
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Leivestad
authors.forename: Jo
authors.initials: J
authors.lastname: Røislien
authors.forename: Trond
authors.initials: T
authors.lastname: Jenssen
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control; D005951:Glucose Tolerance Test; D015796:HLA-B27 Antigen / Q000235:genetics; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D008875:Middle Aged; D018579:Patient Selection; D010641:Phenotype; D011183:Postoperative Complications / Q000453:epidemiology*
chemical_list: D015796:HLA-B27 Antigen