Original Paper

Predictors of New Onset of Diabetes after Transplantation in Stable Renal Recipients
Walid Shehab-Eldin, Ahmed Shoker

Royal University Hospital, Department of Medicine, Division of Nephrology, University of Saskatchewan, Saskatoon, Sask., Canada

Address of Corresponding Author

Nephron Clin Pract 2008;110:c1-c9 (DOI: 10.1159/000148207)

  Key Words

• Insulin resistance
• New onset of diabetes after transplantation
• Renal transplant

  Abstract

Background: Several groups identified pre-transplant factors which contribute to the development of new onset of diabetes after transplantation (NODAT). Aim: To identify post-transplant risk factors for NODAT. Methods: 55 stable renal transplant patients were divided into group A of 34 recipients with normoglycemia and group B of 21 recipients with impaired fasting glucose. Markers including insulin, pro-insulin, soluble receptors for advanced glycated end products (sRAGE), adiponectin, malondialdehyde, homeostasis model assessment of insulin resistance (HOMA-IR), and -cell function were calculated at the outset and correlated, thereafter, with the later development of NODAT after a follow-up duration of 14.98 ± 3.97 months. Results: 11.8 and 19% of groups A and B respectively developed NODAT. Insulin, sRAGE, HOMA-IR and basal fasting plasma glucose correlated with the development of NODAT in univariate analysis. A baseline insulin level of 54.54 mU/l predicted the development of NODAT with a specificity of 95.45% and was the only significant factor in the multivariate analysis. -Cell function was not different among the three groups. Conclusions: A long prodrome of insulin resistance (IR) exists prior to development of NODAT. 50% of patients with NODAT will remit to a normoglycemic state. IR, rather than -cell dysfunction, precedes the development of NODAT. Serum insulin in stable non-diabetic renal transplant patients can be used as a confirmatory test to the development of future NODAT.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Ahmed Shoker, MD, FRCPC
Director of Transplant Program, Department of Medicine
Division of Nephrology, University of Saskatchewan
103 Hospital Drive, Saskatoon, SK S7N 0W8 (Canada)
Tel. +1 306 966 2630, Fax +1 306 966 7996, E-Mail shoker@sask.usask.ca

  Article Information

Received: January 16, 2008
Accepted: April 1, 2008
Published online: July 24, 2008
Number of Print Pages : 9
Number of Figures : 2, Number of Tables : 5, Number of References : 36