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Hyperglycemia and Diabetes Mellitus Following Organ Transplantation

  • Hospital Management of Diabetes (GE Umpierrez, Section Editor)
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Abstract

Hyperglycemia is common following organ transplantation, regardless of the pre-transplant diabetes status. Transient post-transplant hyperglycemia and/or new-onset diabetes after transplantation (NODAT) are common and are associated with increased morbidity and mortality. NODAT and type 2 diabetes share similar characteristics, but the pathophysiology may differ. Immunosuppressive agents and steroids play a key role in the development of NODAT. Glycemic control is challenging in this population due to fluctuating renal/end-organ function, immunosuppressive dosing, nutritional status, and drug-drug interactions. A proactive and multidisciplinary approach is essential, along with flexible protocols to adjust to patient status, type of organ transplanted, and corticosteroid regimens. Insulin is the preferred agent for hospitalized patients and during the early post-transplant period; optimal glycemic control (BG < 180 mg/dl with minimal hypoglycemia [<70 mg/dl]) is desired.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes, and Bone Diseases, Icahn School of Medicine at Mount Sinai, Mount Sinai St. Luke’s Hospital, 1111 Amsterdam Ave, Babcock Building, 10th floor, Room 1020, New York, NY, 10025, USA

    Rodolfo J. Galindo

  2. Division of Endocrinology, Metabolism and Molecular Medicine, Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, 654 N Michigan Avenue, Suite 530, Chicago, IL, 60611, USA

    Amisha Wallia

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Rodolfo J. Galindo declares that he has no conflict of interest. Amisha Wallia currently receives research salary support from Merck Sharp and Dohme Corp.

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Galindo, R.J., Wallia, A. Hyperglycemia and Diabetes Mellitus Following Organ Transplantation. Curr Diab Rep 16, 14 (2016). https://doi.org/10.1007/s11892-015-0707-1

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