Post-transplant diabetes or New onset diabetes mellitus after transplant (NODAT) is a subtype of type 2 diabetes. According to 2011 United States Renal Data System (USRDS) data, more than 40 % of the patients receiving a kidney from the donor develop NODAT within the next three years. Nevertheless, it is not exclusive to kidney transplant patients.
When To Screen For Post-Transplant Diabetes?
Screening for NODAT after an organ transplant is of paramount importance considering its effects on the patient’s health. However, there is no standard time limit for when to screen.
As a matter of fact, the blood glucose levels rise due to a number of other causes such as stress due to surgery or intake of steroid-containing medications. This can give a false idea about NODAT. Thus, you might have to wait for at least 3 months after the surgery. Also, experts recommend the screening to be made when the dose of prednisone is less than 10 mg per day.
NODAT: What Factors Increase the Risk?
Many factors contribute to NODAT including:
- African American or Hispanic origin
- Diagnosis of hepatitis C in the past
- The family history of diabetes
- Old age at the time of the transplant
- Previous history of insulin resistance (not necessarily type 2 diabetes)
What Are The Available Treatments?
When a patient develops NODAT, the first step in the treatment is to lower the blood glucose level. For this purpose, the doctors often recommend intensive insulin therapy. Some patients may also be given oral or injectable medications like metformin, Sitagliptin, Exenatide, and glipizide. The choice of the medication depends on the evaluation of the risks and benefits.
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What Are The Complications of NODAT?
Having persistent high blood sugar after an organ transplant increases the risk of:
- Rejection of the new organ
- Other infections
- Heart disorders
- Death due to any of the causes mentioned above
The Bottom Line
The increased risk of diabetes due to the effects of an organ transplant is a new yet critical health issue. Thus, it is important all the members of the health care team including the transplant team, the primary provider, the diabetes care provider, and the patient stay in close communication.