POST TRANSPLANT DM

Question 1

What is the prevalence of NODAT in kidney transplant recipients?

Answer 1

~33%

Question 2

What are some risk factors for NODAT?

Answer 2

• Increased age
• Obesity
• African American or Hispanic ethnicity
• Family history of diabetes
• Certain antirejection medications (e.g., glucocorticoids)

Question 3

What are the diagnostic criteria for NODAT?

Answer 3

Same general population

Question 4

What is the first step in the management strategy for NODAT?

Answer 4

Lifestyle management and oral treatment with a sulfonylurea

Question 5

What medication is often used as first-line therapy for NODAT?

Answer 5

Metformin

Question 6

Why is metformin preferred in NODAT management?

Answer 6

It may counteract weight gain from immunosuppressants

Question 7

Is the risk of lactic acidosis a major concern in well-functioning allografts when using metformin?

Answer 7

No

Question 8

Why are thiazolidinediones not recommended for NODAT?

Answer 8

Due to fluid retention

Question 9

What should be done with glucocorticoid dosage in the management of hyperglycemia?

Answer 9

Decrease the dosage

Question 10

When is insulin therapy recommended in the management of NODAT?

Answer 10

Only after oral medications if needed

Question 11

What is the target hemoglobin A1c level for NODAT management?

Answer 11

Below 7.0% (<53 mmol/mol)

Question 12

What is the higher hemoglobin A1c level that should not be the target in NODAT management?

Answer 12

8.0% (64 mmol/mol)