title: Cellular and physiological mechanisms of new-onset diabetes mellitus after solid organ transplantation.
abstract: New-onset diabetes after transplantation is recognized as one of the metabolic consequences which may increase the risk of morbidity and mortality after solid organ transplantation. The pathophysiology of new-onset diabetes after transplantation has not been clearly defined and may resemble that of Type 2 diabetes, characterized by predominantly insulin resistance or defective insulin secretion, or both. This review aims to summarize the current state of knowledge regarding the prevalence, consequences, pathogenesis, and management of new-onset diabetes after transplantation, with a major focus on the possible mechanisms involved in the pathogenesis of the disorder. The aetiology of new-onset diabetes after transplantation is multifactorial, with diabetogenic immunosuppressive drugs playing a major role. Multiple cellular and physiologic mechanisms are involved in the process. Selection of an appropriate maintenance immunosuppressive regimen should involve balancing the risk of patient and graft survival vs. the potential for new-onset diabetes after transplantation.
authors.affiliation: Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55902, USA.
authors.forename: M
authors.initials: M
authors.lastname: Dong
authors.forename: A K
authors.initials: AK
authors.lastname: Parsaik
authors.forename: N L
authors.initials: NL
authors.lastname: Eberhardt
authors.forename: A
authors.initials: A
authors.lastname: Basu
authors.forename: F G
authors.initials: FG
authors.lastname: Cosio
authors.forename: Y C
authors.initials: YC
authors.lastname: Kudva
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology / Q000401:mortality / Q000503:physiopathology*; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007328:Insulin / Q000627:therapeutic use*; D007333:Insulin Resistance; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D016377:Organ Transplantation / Q000009:adverse effects* / Q000401:mortality; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D007328:Insulin