title: Antidiabetic therapy in post kidney transplantation diabetes mellitus.
abstract: Post-transplantation diabetes mellitus (PTDM) is a common complication after kidney transplantation that affects up to 40% of kidney transplant recipients. By pathogenesis, PTDM is a diabetes form of its own, and may be characterised by a sudden, drug-induced deficiency in insulin secretion rather than worsening of insulin resistance over time. In the context of deteriorating allograft function leading to a re-occurrence of chronic kidney disease after transplantation, pharmacological interventions in PTDM patients deserve special attention. In the present review, we aim at presenting the current evidence regarding efficacy and safety of the modern antidiabetic armamentarium. Specifically, we focus on incretin-based therapies and insulin treatment, besides metformin and glitazones, and discuss their respective advantages and pitfalls. Although recent pilot trials are available in both prediabetes and PTDM, further studies are warranted to elucidate the ideal timing of various antidiabetics as well as its long-term impact on safety, glucose metabolism and cardiovascular outcomes in kidney transplant recipients.
authors: Department of Medicine 3, Division of Nephrology and Dialysis, Medical University of Vienna, Austria. Electronic address: Johannes.werzowa@meduniwien.ac.at.
authors: Johannes
authors: J
authors: Werzowa
authors: Department of Medicine 3, Division of Nephrology and Dialysis, Medical University of Vienna, Austria.
authors: Marcus
authors: M
authors: Säemann
authors: Department of Medicine 3, Division of Nephrology and Dialysis, Medical University of Vienna, Austria.
authors: Michael
authors: M
authors: Haidinger
authors: Department of Medicine 3, Division of Endocrinology and Metabolism, Medical University of Vienna, Austria.
authors: Michael
authors: M
authors: Krebs
authors: Department of Medicine 3, Division of Nephrology and Dialysis, Medical University of Vienna, Austria.
authors: Manfred
authors: M
authors: Hecking
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents