Post transplantation diabetes mellitus in kidney allograft recipients: current concepts

The number of kidney allograft recipients has been increasing worldwide and along with that is a proportional rise in the number of individuals who develop post-transplantation diabetes mellitus (PTDM). It is therefore necessary that physicians who render care to transplant recipients, be conversant with the current issues that relate to this relatively common complication. We searched the Medline using the keywords diabetes, transplantation, kidney and PTDM, and retrieved all relevant articles that were published in the last 15 years up to 2008. Post-transplantation diabetes mellitus is a common complication following renal trans-plantation affecting approximately 10 to 20% of such patients. In the majority of the studies we reviewed, PTDM was similar to diabetes in non-transplant patients and the risk factors included older age at transplantation, family history of diabetes, obesity, elevated body mass index, non-white ethnicity and the use of steroids and several immunosuppressive agents. Curtailment of the heavy disease burden associated with PTDM should lay emphasis on pro-active preventive measures that are aimed at modifying the known risk factors and the individualized use of immunosuppressive agents determined by the pre-transplant risk profile of the patient.