Steroid-induced diabetes in pediatric renal transplant recipients

Abstract

Seven patients in a series of 79 children receiving 101 kidney transplants developed steroid-induced diabetes. Black children, recipients of cadaveric allografts, and patients receiving higher average daily prednisone dosage were more likely to develop hyperglycemia. The diabetes was transient and easily controlled. No patient developed permanent insulin dependence. No patients exhibited is let cell autoantibodies or an HLA haplotype associated with diabetes. Oral glucose tolerance testing demonstrated significant hyperglycemia with an inadequate insulin response. Three patients also exhibited unusual complications; two had cerebral vascular accidents (CVA) and one developed aspergillosis in a native kidney. Pediatric patients exhibiting steroid-induced diabetes following kidney transplantation may constitute a group at greater risk for complications.