Therapeutic management of posttransplant diabetes mellitus.
Diabetes mellitus continues to be a common metabolic complication after solid organ transplantation. The etiology is multifactorial and includes both modifiable and nonmodifiable factors. Immunosuppression may play a critical role in its development. Targets of treatment include oral hypoglycemics as well as insulin. More recently, several novel agents have been approved by the Food and Drug Administration for treatment of type 2 diabetes. There is limited experience with these agents in transplant recipients. Use of oral and subcutaneous therapies as well as insulin will be reviewed. As diabetes has a negative impact on patient and graft outcome, the transplant practitioner must be vigilant in screening and managing diabetes after transplantation.
Mannon
Roslyn B
RB
Transplantation Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, MD 20892, USA. rozm@mail.nih.gov
D001741:Black or African American; D000367:Age Factors; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use*; D009765:Obesity / Q000150:complications; D016377:Organ Transplantation / Q000009:adverse effects*; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects
D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D007328:Insulin; D016559:Tacrolimus