New-onset diabetes mellitus after kidney transplantation in Denmark.
OBJECTIVE
This study aimed to investigate the development of new-onset diabetes mellitus (NODM) in a prospective study of 97 nondiabetic uremic patients.


METHODS
Included were 57 kidney recipients (Tx group, age 39 +/- 13 years) and 40 uremic patients remaining on the waiting list for kidney transplantation (uremic controls, age 47 +/- 11 years). All were examined at baseline before possible transplantation and after 12 months. The prevalence of diabetes, prediabetes, insulin sensitivity index (ISI), and insulin secretion index (Isecr) were estimated using an oral glucose tolerance test with measurements of plasma glucose and plasma insulin.


RESULTS
One year after transplantation NODM was present in 14% (8 of 57) compared with 5% (2 of 40) in the uremic control group (P = 0.01). ISI in the Tx group deteriorated from 6.8 +/- 3.9 before transplantation to 4.9 +/- 2.8 at 12 months after transplantation (P = 0.005), and a slight increase in Isecr from 37 +/- 19 to 46 +/- 22 (P = 0.02) was seen. No significant changes occurred in the uremic controls (ISI was 7.9 +/- 5 and 8.5 +/- 5, and Isecr was 31 +/- 17 and 28 +/- 15). Using multivariate ordinal logistic regression, pre-Tx ISI and age predicted NODM (odds ratios: 0.82, P = 0.01 and 1.06, P = 0.02, respectively).


CONCLUSIONS
One year after kidney transplantation, NODM was present in 14% of patients. This was mainly caused by an increase in insulin resistance and was observed despite improvement in insulin secretion.
Hornum
Mads
M
Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, P 2131, DK-2100 Copenhagen, Denmark. mads.hornum@rh.regionh.dk
Jørgensen
Kaj Anker
KA
Hansen
Jesper Melchior
JM
Nielsen
Finn Thomsen
FT
Christensen
Karl Bang
KB
Mathiesen
Elisabeth R
ER
Feldt-Rasmussen
Bo
B
D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005951:Glucose Tolerance Test; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011236:Prediabetic State / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014511:Uremia / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
D001786:Blood Glucose; D007166:Immunosuppressive Agents; D007328:Insulin