title: Prevention and management of transplant-associated diabetes.
abstract: BACKGROUND
  New-onset diabetes after transplantation (NODAT) is considered to be a major cause of cardiovascular disease and death among patients with a functioning allograft. A major challenge is to reduce the incidence of NODAT and to treat it optimally once it has occurred.
  
  
  METHODS
  This review presents current data on how to prevent NODAT in patients at risk, with a focus on modifications in the immunosuppressive regimen. Current suggestions for detection and treatment of NODAT are also presented.
  
  
  CONCLUSIONS
  Prevention of NODAT is possible by assessing the patient's glycemic risk prior to transplantation and tailoring the treatment (e.g., choice and dosage of immunosuppressive agents) after transplantation. An oral glucose tolerance test is still the gold standard to detect NODAT in patients at risk (prediabetes) but algorithms can be used to select those who should be tested. The treatment of NODAT involves a broad approach on risk factors for cardiovascular events and graft loss. Future studies on the use of oral hypoglycemic agents in NODAT are still needed.
authors: Oslo University Hospital Rikshospitalet, Section of Nephrology, Department of Organ Transplantation, Oslo, Norway. trond.jenssen@ous-hf.no
authors: Trond
authors: T
authors: Jenssen
authors: Anders
authors: A
authors: Hartmann
mesh_terms: D000818:Animals; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016377:Organ Transplantation / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents