title: New-onset diabetes after transplantation in tacrolimus-treated, living kidney transplantation: long-term impact and utility of the pre-transplant OGTT.
abstract: BACKGROUND
  To evaluate the role of the oral glucose tolerance test (OGTT) before transplantation and to examine the risk factors for new-onset diabetes after transplantation (NODAT) during long-term follow-up of renal transplant recipients receiving FK-based therapy.
  
  
  METHODS
  The study evaluated 378 patients pre-transplantation using the OGTT and assigned them to one of three groups: Group 1, normal pattern; Group 2, impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) pattern (IFG/IGT); and Group 3, DM pattern.
  
  
  RESULTS
  Although the incidence of NODAT was higher in Group 3 than in groups 1 and 2, no significant difference was found between the three groups with regard to graft survival during long-term follow-up. Multivariate analysis showed that only a family history of diabetes was a significant factor determining NODAT progression.
  
  
  CONCLUSIONS
  Impaired glucose tolerance appears to be a threshold influencing NODAT; however, it was not a significant factor in graft survival. Careful monitoring and management based on the result of the pre-transplantation OGTT appear to prevent the deterioration of impaired glucose tolerance in renal transplant recipients receiving FK-based therapy, even when a pre-operative OGTT shows impaired glycemic control.
authors.affiliation: Section of Renal Transplantation/Renovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. sho.i@f4.dion.ne.jp
authors.forename: Shoichi
authors.initials: S
authors.lastname: Iida
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishida
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Tokumoto
authors.forename: Kazuya
authors.initials: K
authors.lastname: Omoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirakawa
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Shimizu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Amano
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Setoguchi
authors.forename: Taiji
authors.initials: T
authors.lastname: Nozaki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Toki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tokita
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000139:chemically induced*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D016559:Tacrolimus / Q000009:adverse effects*; D013997:Time Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus