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Multicenter Study
. 2010 Apr;5(4):709-16.
doi: 10.2215/CJN.05360709. Epub 2010 Feb 18.

New-onset diabetes mellitus after kidney transplantation in Denmark

Mads Hornum  1 , Kaj Anker Jørgensen, Jesper Melchior Hansen, Finn Thomsen Nielsen, Karl Bang Christensen, Elisabeth R Mathiesen, Bo Feldt-Rasmussen
Affiliations
Multicenter Study

New-onset diabetes mellitus after kidney transplantation in Denmark

Mads Hornum et al. Clin J Am Soc Nephrol. 2010 Apr.

Abstract

Background and objectives: This study aimed to investigate the development of new-onset diabetes mellitus (NODM) in a prospective study of 97 nondiabetic uremic patients.

Design, setting, participants, & measurements: Included were 57 kidney recipients (Tx group, age 39 +/- 13 years) and 40 uremic patients remaining on the waiting list for kidney transplantation (uremic controls, age 47 +/- 11 years). All were examined at baseline before possible transplantation and after 12 months. The prevalence of diabetes, prediabetes, insulin sensitivity index (ISI), and insulin secretion index (Isecr) were estimated using an oral glucose tolerance test with measurements of plasma glucose and plasma insulin.

Results: One year after transplantation NODM was present in 14% (8 of 57) compared with 5% (2 of 40) in the uremic control group (P = 0.01). ISI in the Tx group deteriorated from 6.8 +/- 3.9 before transplantation to 4.9 +/- 2.8 at 12 months after transplantation (P = 0.005), and a slight increase in Isecr from 37 +/- 19 to 46 +/- 22 (P = 0.02) was seen. No significant changes occurred in the uremic controls (ISI was 7.9 +/- 5 and 8.5 +/- 5, and Isecr was 31 +/- 17 and 28 +/- 15). Using multivariate ordinal logistic regression, pre-Tx ISI and age predicted NODM (odds ratios: 0.82, P = 0.01 and 1.06, P = 0.02, respectively).

Conclusions: One year after kidney transplantation, NODM was present in 14% of patients. This was mainly caused by an increase in insulin resistance and was observed despite improvement in insulin secretion.

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Figures

Figure 1.
Figure 1.
Individual results of OGTTs in 57 renal transplantation patients before at time 0 and 12 months after transplantation (upper panel) and in 40 uremic patients at 0 and 12 months (lower panel). DM, diabetes mellitus; NGT, normal glucose tolerance.
Figure 2.
Figure 2.
Change in ISI after kidney transplantation.
Figure 3.
Figure 3.
Change in Isecr after kidney transplantation.
See this image and copyright information in PMC

Comment in

References

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