New-onset diabetes after transplantation in tacrolimus-treated, living kidney transplantation: long-term impact and utility of the pre-transplant OGTT.
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.
Iida
Shoichi
S
Section of Renal Transplantation/Renovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. sho.i@f4.dion.ne.jp
Ishida
Hideki
H
Tokumoto
Tadahiko
T
Omoto
Kazuya
K
Shirakawa
Hiroki
H
Shimizu
Tomokazu
T
Amano
Hiroyuki
H
Setoguchi
Kiyoshi
K
Nozaki
Taiji
T
Toki
Daisuke
D
Tokita
Daisuke
D
Tanabe
Kazunari
K
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
D007166:Immunosuppressive Agents; D016559:Tacrolimus