New Onset Diabetes After Organ Transplantation: Risk Factors, Treatment, and Consequences

被引：0
作者：
Popovic, Lucija [1 ]
Bulum, Tomislav [2 ,3 ]
机构：
[1] Univ Hosp Ctr Zagreb, Dept Emergency Med, Kispaticeva 12, Zagreb 10000, Croatia
[2] Univ Zagreb, Sch Med, Salata 3, Zagreb 10000, Croatia
[3] Vuk Vrhovac Univ, Merkur Univ Hosp, Dept Diabet & Endocrinol, Clin Diabet Endocrinol & Metab Dis, Dugi dol 4a, Zagreb 10000, Croatia
来源：
DIAGNOSTICS | 2025年 / 15卷 / 03期
关键词：
new onset diabetes after organ transplantation; risk factors; immunosuppressive medication; diabetes; RENAL-TRANSPLANTATION; KIDNEY-TRANSPLANTATION; INSULIN-RESISTANCE; METABOLIC SYNDROME; MELLITUS; CYCLOSPORINE; RECIPIENTS; HYPOMAGNESEMIA; HYPERGLYCEMIA; NEPHROPATHY;
D O I：
10.3390/diagnostics15030284
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
New onset diabetes mellitus after organ transplantation (NODAT) is a frequent and serious complication of solid organ transplantation. It significantly impacts graft function, patient survival, and quality of life. NODAT is diagnosed based on the criteria for type 2 diabetes, with the oral glucose tolerance test (OGTT) serving as the gold standard for diagnosis. The development of NODAT is influenced by a range of risk factors, which are classified into modifiable and non-modifiable categories. Post-transplant, regular glycemic monitoring at specific intervals is essential for timely diagnosis and initiation of therapy. Early intervention can help prevent or delay the onset of diabetes-related complications. The treatment strategy for NODAT involves lifestyle modifications and pharmacological interventions. These include medications such as metformin, sulfonylureas, glinides, thiazolidinediones, DPP-4 inhibitors, GLP-1 agonists, SGLT-2 inhibitors, and insulin. Adjusting immunosuppressive therapy-either by reducing dosages or substituting drugs with lower diabetogenic potential-is a common preventative and therapeutic measure. However, this must be performed cautiously to avoid acute graft rejection, which poses a greater risk to the patient compared to NODAT itself. In addition to managing diabetes, addressing comorbidities such as hypertension and dyslipidemia is crucial, as they elevate the risk of cardiovascular events and mortality. Patients with NODAT are also prone to developing common diabetes-related complications, including diabetic nephropathy, neuropathy, retinopathy, and peripheral vascular disease. Therefore, regular follow-ups and appropriate treatment are vital to maintaining quality of life and improving long-term outcomes.
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页数：28
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