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 - http://dx.doi.org/10.2215/CJN.05360709
DO - http://dx.doi.org/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 -
