Prevalence and risk factors of new-onset diabetes after transplantation: A single-center experience

Abstract

New-onset diabetes after transplantation (NODAT) is a serious complication following solid organ transplantation. NODAT occurs in 2.5% to 40% of all solid organ transplant recipients. The identification of high-risk patients and the implementation of measures to limit the development of NODAT can improve the long-term prognosis of patients. The present study aimed to assess NODAT frequency and risk factors in kidney transplant recipients.

Methods. A cohort of 103 kidney transplant patients was included in this retrospective single-center study, excluding 31 with pre-existing diabetes. The remaining 72 were divided into NODAT (n=17) and non-NODAT (n=55) groups. The logistic regression analysis was used to assess the risk factors for NODAT.

Results. NODAT occurred in 17 (23.6%) out of 72 patients without diagnosed diabetes before kidney transplantation. Age was significantly associated with increased NODAT risk (p<0.0001). Pre-transplant impaired fasting plasma glucose (FPG) and impaired glucose tolerance were significant predictors of NODAT. A statistically significant correlation was found between fasting plasma glucose (FPG) and postprandial blood glucose levels at various time points during the first month post-transplantation, and the development of NODAT. Similarly, patients requiring temporary insulin during hospitalization after transplantation had a significantly increased risk of NODAT. Multivariate analysis identified age ≥45 years (p=0.01), pre-transplant impaired FPG (p=0.001), post-transplant insulin requirement (p=0.01), and first-month tacrolimus levels (p=0.04) as statistically significant independent risk factors for NODAT development.

Conclusion. Age over 45 years, pre-transplant impaired FPG, perioperative insulin requirement, and first-month tacrolimus blood concentration were identified as independent factors associated with the development of NODAT.