New-onset diabetes mellitus after kidney transplantation in Denmark

TY - JOUR

T1 - New-onset diabetes mellitus after kidney transplantation in Denmark

AU - Hornum, Mads

AU - Jørgensen, Kaj Anker

AU - Hansen, Jesper Melchior

AU - Nielsen, Finn Thomsen

AU - Christensen, Karl Bang

AU - Mathiesen, Elisabeth R

AU - Feldt-Rasmussen, Bo

PY - 2010/4/1

Y1 - 2010/4/1

N2 - Background and objectives: This study aimed to investigate the development of new-onset diabetes mellitus (NODM) in a prospective study of 97 nondiabetic uremic patients. Design, setting, participants, & measurements: Included were 57 kidney recipients (Tx group, age 39 ± 13 years) and 40 uremic patients remaining on the waiting list for kidney transplantation (uremic controls, age 47 ± 11 years). All were examined at baseline before possible transplantation and after 12 months. The prevalence of diabetes, prediabetes, insulin sensitivity index (ISI), and insulin secretion index (Isecr) were estimated using an oral glucose tolerance test with measurements of plasma glucose and plasma insulin. Results: One year after transplantation NODM was present in 14% (8 of 57) compared with 5% (2 of 40) in the uremic control group (P = 0.01). ISI in the Tx group deteriorated from 6.8 ± 3.9 before transplantation to 4.9 ± 2.8 at 12 months after transplantation (P = 0.005), and a slight increase in Isecr from 37 ± 19 to 46 ± 22 (P = 0.02) was seen. No significant changes occurred in the uremic controls (ISI was 7.9 ± 5 and 8.5 ± 5, and Isecr was 31 ± 17 and 28 ± 15). Using multivariate ordinal logistic regression, pre-Tx ISI and age predicted NODM (odds ratios: 0.82, P = 0.01 and 1.06, P = 0.02, respectively). Conclusions: One year after kidney transplantation, NODM was present in 14% of patients. This was mainly caused by an increase in insulin resistance and was observed despite improvement in insulin secretion.

AB - Background and objectives: This study aimed to investigate the development of new-onset diabetes mellitus (NODM) in a prospective study of 97 nondiabetic uremic patients. Design, setting, participants, & measurements: Included were 57 kidney recipients (Tx group, age 39 ± 13 years) and 40 uremic patients remaining on the waiting list for kidney transplantation (uremic controls, age 47 ± 11 years). All were examined at baseline before possible transplantation and after 12 months. The prevalence of diabetes, prediabetes, insulin sensitivity index (ISI), and insulin secretion index (Isecr) were estimated using an oral glucose tolerance test with measurements of plasma glucose and plasma insulin. Results: One year after transplantation NODM was present in 14% (8 of 57) compared with 5% (2 of 40) in the uremic control group (P = 0.01). ISI in the Tx group deteriorated from 6.8 ± 3.9 before transplantation to 4.9 ± 2.8 at 12 months after transplantation (P = 0.005), and a slight increase in Isecr from 37 ± 19 to 46 ± 22 (P = 0.02) was seen. No significant changes occurred in the uremic controls (ISI was 7.9 ± 5 and 8.5 ± 5, and Isecr was 31 ± 17 and 28 ± 15). Using multivariate ordinal logistic regression, pre-Tx ISI and age predicted NODM (odds ratios: 0.82, P = 0.01 and 1.06, P = 0.02, respectively). Conclusions: One year after kidney transplantation, NODM was present in 14% of patients. This was mainly caused by an increase in insulin resistance and was observed despite improvement in insulin secretion.

U2 - 10.2215/CJN.05360709

DO - 10.2215/CJN.05360709

M3 - Journal article

SN - 1555-9041

VL - 5

SP - 709

EP - 716

JO - Clinical Journal of American Society of Nephrology.

JF - Clinical Journal of American Society of Nephrology.

IS - 4

ER -