title: Incidence and risk factors for development of new-onset diabetes after kidney transplantation.
abstract: BACKGROUND
  New-onset diabetes after transplantation (NODAT) is an increasingly recognised metabolic complication of kidney transplantation that is associated with increased morbidity and mortality. This study aimed to determine the incidence of NODAT and identify risk factors for development of NODAT among kidney allograft recipients in a single centre.
  
  
  METHODS
  We retrospectively reviewed all kidney allograft recipients in our centre between 1998 and 2007. NODAT were determined using criteria as per American Diabetes Association guidelines. Logistic regression analyses were performed to identify predictors of NODAT.
  
  
  RESULTS
  Among 388 patients included in the analysis, NODAT was reported in 94 patients (24.2%) after a median follow-up time of 52.1 months. The cumulative incidence of NODAT was 15.8%, 22.8% and 24.5% at 1, 3, and 5 years following transplantation. Seven clinical factors were independent predictors of NODAT: older age, HLA B13 and B15 phenotypes, use of sirolimus, acute rejections, higher pre-transplant and post-transplant (day 1) plasma glucose levels. Patients with NODAT had poorer outcomes in both graft and patient survival.
  
  
  CONCLUSIONS
  Our study demonstrates a significant risk and burden of NODAT in an Asian transplant population. Risk stratification and aggressive monitoring of blood glucose early post-transplantation is necessary to identify high-risk patients so that appropriate tailoring of immunosuppression and early institution of lifestyle modifications can be implemented.
authors.affiliation: Department of Endocrinology, Singapore General Hospital. bee.yong.mong@sgh.com.sg
authors.forename: Yong Mong
authors.initials: YM
authors.lastname: Bee
authors.forename: Hong Chang
authors.initials: HC
authors.lastname: Tan
authors.forename: Tunn Lin
authors.initials: TL
authors.lastname: Tay
authors.forename: Terence Ys
authors.initials: TY
authors.lastname: Kee
authors.forename: Su Yen
authors.initials: SY
authors.lastname: Goh
authors.forename: Peng Chin
authors.initials: PC
authors.lastname: Kek
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000209:etiology* / Q000235:genetics; D005260:Female; D006084:Graft Rejection / Q000150:complications; D015235:HLA-B Antigens / Q000032:analysis; D006801:Humans; D007166:Immunosuppressive Agents; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D015235:HLA-B Antigens; D007166:Immunosuppressive Agents