Diabetes mellitus after hematopoietic stem cell transplantation.
OBJECTIVE
To review the current literature on posttransplant diabetes mellitus after hematopoietic stem cell transplantation, including its epidemiologic features, transplant-related risk factors, and treatment.


METHODS
A literature search was conducted in PubMed for articles on diabetes mellitus after hematopoietic stem cell transplantation and effects of immunosuppressants on glucose metabolism.


RESULTS
Within 2 years after hematopoietic stem cell transplantation, up to 30% of patients may have diabetes. Although some of these cases resolve, the rates of diabetes and metabolic syndrome remain elevated in comparison with those in the nontransplant patient population during long-term follow-up. Traditional risk factors for diabetes as well as features related to the transplantation process, including immunosuppressive medications, are associated with posttransplant diabetes. Cardiovascular risk also appears to be increased in this population. Limited data are available on hypoglycemic agents for posttransplant diabetes; thus, treatment decisions must be based on safety, efficacy, and tolerability, with consideration of each patient's transplant-related medications and comorbidities.


CONCLUSIONS
Treatment of diabetes mellitus in patients who have undergone hematopoietic stem cell transplantation necessitates attention to the posttransplant medication regimen and clinical course. Although no guidelines specific to treatment of posttransplant diabetes in this patient population currently exist, treatment to goals similar to those for nontransplant patients with diabetes should be considered in an attempt to help reduce long-term morbidity and mortality.
Griffith
Michelle L
ML
Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-8148, USA.
Jagasia
Madan
M
Jagasia
Shubhada M
SM
D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D000075202:Contraindications; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology* / Q000378:metabolism / Q000628:therapy; D050171:Dyslipidemias / Q000453:epidemiology; D005947:Glucose / Q000378:metabolism; D006086:Graft vs Host Disease / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D024821:Metabolic Syndrome / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors
D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D005947:Glucose