[Post-transplantation diabetes mellitus]

Abstract

Post-transplant diabetes mellitus is a frequent and serious complication after organ transplantation. Its ethiopathogenesis is complex, with interaction between intrinsic factors (older age, body mass index, individual and family history, hepatitis C virus infection) and graft related factors (immunosuppressive regimen, HLA status). In kidney transplant recipients, new onset diabetes mellitus is associated with an adverse effect upon patient survival, with an increased incidence of infectious and cardiovascular complications. Furthemore, post transplant diabetes mellitus clearly affects long-term allograft survival. Management of new onset diabetes mellitus after transplantation includes: screening for risk factors before transplantation (to propose lifestyle modifications and adaptation of immunosuppressive therapy); regular monitoring of glycemia after transplantation; non pharmacologic and pharmacologic therapies associated with management of others cardiovascular risk factors (hypertension, dyslipidemias).