New-Onset Diabetes Mellitus after Kidney Transplantation
This review of new-onset diabetes after kidney transplantation (NODAT) describes its impact on graft and patient survival and calls for more anticipatory, personalized post-transplant care to catch and manage the condition earlier.
Background
NODAT is a prevalent complication after kidney transplantation, with reported incidence varying by definition and follow-up duration; its pathophysiology involves impaired insulin sensitivity and beta-cell dysfunction, worsened by post-transplant immunosuppressive drugs.
Key findings
Risk factors include age, gender, obesity, and genetic predisposition, compounded by immunosuppressive regimens necessary for graft survival. NODAT meaningfully affects both patient survival and graft durability.
Clinical implications
Management involves balancing immunosuppressive drug adjustments, lifestyle modification, and pharmacologic glucose control; the authors advocate a shift toward earlier detection and more anticipatory, personalized post-transplant care to modify NODAT's trajectory.
Category
Transplant
Source
Journal of Clinical Medicine
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