Management of new onset diabetes after transplantation (NODAT) with use of novel algorithm

Corticosteroids, calcineurin inhibitors, and mTOR inhibitors are often used as an immunosuppressant in patients after solid-organ transplant. These agents can lead to significant hyperglycemia which is called "New onset of diabetes after transplantation (NODAT)". Tight-glycemic control in patients with NODAT not only reduces the risk of post-transplant infection and graft failure but also reduces the long-term morbidity and mortality. Management of patients with NODAT is complicated because changes in doses of immunosuppressant can lead to change in glycemic status. Here, we present a series of cases involving successful management of hyperglycemia among outpatient department (OPD) patients with NODAT using a novel algorithm which negates the glycemic effects of corticosteroids and calcineurin inhibitors. We have also described the basic components of the algorithm which can be useful for physicians who deal with NODAT.