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Posttransplantionsdiabetes

Diagnostische und therapeutische Strategien

New onset diabetes after transplantation

Diagnostic and therapeutic strategies

  • Leitthema
  • Published:
Der Diabetologe Aims and scope

Zusammenfassung

Ein nach Transplantation neu auftretender Diabetes mellitus ist ein häufiges Ereignis und führt häufiger zu Tod, Transplantatversagen sowie im Langzeitverlauf zur Progression mikro- und makrovaskulärer Morbidität. Daher gilt es bereits zum Zeitpunkt der Evaluation zur Aufnahme auf eine Transplantationswarteliste sowie im Posttransplantationsverlauf, ein standardisiertes prospektives Setting zur frühzeitigen Detektion hyperglykämischer Stoffwechelsentgleisungen zu implementieren, welches die Durchführung eines oralen Glukosetoleranztests (oGTT) einschließt. Im Hinblick auf eine gleichermaßen konsequente wie auch logistisch und ökonomisch effiziente diagnostische und therapeutische Strategie bieten regionale Kooperationen von Transplantationsmedizinern und Diabetologen mit ihrem Team dafür eine ideale Voraussetzung und sollten entsprechend gefördert werden. Nur dadurch wird eine rechtzeitige therapeutische Intervention ermöglicht und der Gesamttransplantationserfolg hyperglykämischer Transplantatempfänger nachhaltig verbessert.

Abstract

New onset diabetes after transplantation is a common complication leading to progressive microvascular and macrovascular diseases, graft failure and death. Therefore early detection of impaired glycemic control is crucial and standardized screening including an oral glucose tolerance test (OGTT) should be carried out at the time of evaluation before accepting a patient on a transplantation waiting list. In terms of a consistent, logistic and economic efficiency for diagnostic and therapeutic strategies, local and regional cooperation between transplantation physicians and diabetologists and their teams are ideal prerequisites and should be promoted. This approach will allow early diagnosis and therapeutic intervention and lead to optimized overall transplantation success for hyperglycemic transplant recipients.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik III, Universitätsklinikum Giessen und Marburg, Rodthohl 6, 35392, Giessen, Deutschland

    M. Eckhard & R.G. Bretzel

  2. Ärztehaus Harlaching, München, München, Deutschland

    C. Dieterle

  3. Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl-Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland

    M. Brendel

  4. Deutsche Diabetes-Stiftung, München, München, Deutschland

    R. Landgraf

Authors
  1. M. Eckhard
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  2. C. Dieterle
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  3. M. Brendel
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  4. R.G. Bretzel
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  5. R. Landgraf
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Correspondence to M. Eckhard.

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Eckhard, M., Dieterle, C., Brendel, M. et al. Posttransplantionsdiabetes. Diabetologe 6, 460–468 (2010). https://doi.org/10.1007/s11428-010-0567-x

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  • DOI: https://doi.org/10.1007/s11428-010-0567-x

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