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- Title
Post-transplant diabetes mellitus.
- Authors
Chowdhury, Tahseen A.
- Abstract
Post-transplant diabetes mellitus (PTDM) is common following solid organ transplantation, and is a risk factor for graft failure and patient mortality. In addition to standard diabetes risk factors such as obesity and ethnicity, patients undergoing transplantation also have the additional risk factors of immunosuppressive agents and infections such as hepatitis C. Patients undergoing transplant assessment should be screened for diabetes. If non-diabetic, but deemed at high risk, they should be offered careful lifestyle advice to reduce risk of posttransplant weight gain and therefore reduce risk of PTDM. Hyperglycaemia in the early post-operative period should be managed ideally with insulin therapy. Once clinically stable, there may be an opportunity to reduce or stop insulin, and consider oral hypoglycaemic agents. Despite lack of evidence from randomised trials, PTDM should be actively screened for in all transplant recipients, and actively managed with structured education, screening for complications, cardiovascular risk reduction and antihyperglycaemic therapy.
- Subjects
DIAGNOSIS of diabetes; DIABETES prevention; DIABETES risk factors; HYPERGLYCEMIA prevention; INSULIN therapy; WEIGHT gain prevention; HYPOGLYCEMIC agents; WEIGHT gain risk factors; MORTALITY risk factors; OBESITY complications; CARDIOVASCULAR diseases risk factors; ETHNIC groups; GRAFT rejection; HEALTH education; HEPATITIS C; HYPERGLYCEMIA; IMMUNOSUPPRESSIVE agents; MEDICAL screening; ORAL drug administration; POSTOPERATIVE care; TRANSPLANTATION of organs, tissues, etc.; LIFESTYLES; CONTINUING education units; EARLY medical intervention; DISEASE complications; DISEASE risk factors
- Publication
Clinical Medicine, 2019, Vol 19, Issue 5, p392
- ISSN
1470-2118
- Publication type
Article
- DOI
10.7861/clinmed.2019-0195