New Guidelines Call for Steps to Cut Post-Transplant Diabetes

A panel of leading experts has published the first international consensus guidelines aimed at improving the diagnosis, treatment and management of new-onset diabetes in transplant patients.

Prevalence of the condition -- which the experts said affects more than half of organ transplant recipients -- has been underestimated, in part because of a failure to routinely screen patients for high blood sugar levels following transplant.

New-onset diabetes after transplantation increases the risk of organ failure by 63 percent, the experts said, and increases the long-term risk of cardiovascular disease and the risk of death by 87 percent.

The guidelines, drawn up by specialists from the United States, Canada and Europe, call for the close monitoring after transplantation of the two modifiable risk factors for new-onset diabetes: obesity and immunosuppressive therapy.

The report in the journal Transplantation also notes that studies have shown that corticosteroids and tacrolimus are the immunosuppressive drugs most linked to the development of diabetes.

"New-onset diabetes after transplantation is a serious complication which needs to be effectively controlled from the outset," said Dr. Alan H. Wilkinson, Director of the UCLA Kidney and Kidney-Pancreas Transplant Programs and co-chair of panel.

"It is one of the complications most feared by patients contemplating transplantation," Wilkinson said. "Effective management could reduce the numbers of patients affected and proper care of diabetes can significantly help to ensure that the transplant is a success in the long term, that the patient's quality of life is maintained and that healthcare management costs are kept down."

Other Sources: Transplantation