POST TRANSPLANT DM

Question 1

What term was changed in 2014 to refer to new-onset diabetes after transplantation?

Answer 1

Posttransplant diabetes mellitus (PTDM)

This change was made to address issues with pretransplant diabetes identification.

Question 2

What percentage of patients experience hyperglycemia immediately after transplantation?

Answer 2

Up to 90% of patients

This hyperglycemia is often due to surgical stress or high-dose glucocorticoids.

Question 3

When should formal PTDM diagnosis be delayed until to avoid misdiagnosis?

Answer 3

After 6 weeks

Posttransplant hyperglycemia usually resolves within the first few weeks.

Question 4

What are the leading causes of death in kidney transplant recipients linked to PTDM?

Answer 4

Increased mortality, morbidity, cardiovascular disease, and infections

PTDM is associated with these complications.

Question 5

List risk factors for PTDM.

Answer 5

• Older age (≥45 years)
• Obesity (BMI ≥30 kg/m²)
• African American race
• Hispanic ethnicity
• History of gestational diabetes or family diabetes history
• Hepatitis C infection
• Transplant-specific factors such as glucocorticoids and immunosuppressive agents

These factors increase the risk of developing PTDM.

Question 6

Which immunosuppressive agents are known to increase PTDM risk?

Answer 6

Cyclosporine and tacrolimus

Tacrolimus is noted to be more diabetogenic.

Question 7

How do cyclosporine and tacrolimus affect diabetes risk after transplantation?

Answer 7

They affect islet cell function and insulin expression

This contributes to the increased risk of PTDM.