Undiagnosed Diabetes in Kidney Transplant Candidates: A Case-Finding Strategy
Guidelines recommend that candidates for kidney transplantation (KTx) who do not have diabetes perform a pretransplantation oral glucose tolerance test (OGTT) when fasting plasma glucose (FPG) is or =7.0 mmol/L]). In patients with a nondiabetic FPG, diabetes (2-hour plasma glucose [2h-PG] > or =...
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| Veröffentlicht in: | Clinical journal of the American Society of Nephrology 2010-04, Vol.5 (4), p.616-622 |
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| container_title | Clinical journal of the American Society of Nephrology |
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| creator | Bergrem, Henrik Andreas Valderhaug, Tone Gretland Hartmann, Anders Hjelmesaeth, Joran Leivestad, Torbjorn Bergrem, Harald Jenssen, Trond |
| description | Guidelines recommend that candidates for kidney transplantation (KTx) who do not have diabetes perform a pretransplantation oral glucose tolerance test (OGTT) when fasting plasma glucose (FPG) is or =7.0 mmol/L]). In patients with a nondiabetic FPG, diabetes (2-hour plasma glucose [2h-PG] > or =200 mg/dl [> or =11.1 mmol/L]) was predicted by FPG but not by HbA(1c). Performing the OGTT in patients with FPG 92 to 125 mg/dl (5.1 to 6.9 mmol/L) identified 65 (90%) patients with diabetes (16 by FPG, 49 by 2h-PG) and required seven OGTTs per patient identified. Subjecting all patients with FPG |
| doi_str_mv | 10.2215/CJN.07501009 |
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In this cross-sectional study, 889 first single-kidney transplant candidates without diabetes, mainly white, performed an OGTT during the transplantation workup. Results were studied using receiver operating characteristic analysis.
Of 72 (8.1%) patients with undiagnosed diabetes, only 16 (22%) had a diabetic FPG (> or =126 mg/dl [> or =7.0 mmol/L]). In patients with a nondiabetic FPG, diabetes (2-hour plasma glucose [2h-PG] > or =200 mg/dl [> or =11.1 mmol/L]) was predicted by FPG but not by HbA(1c). Performing the OGTT in patients with FPG 92 to 125 mg/dl (5.1 to 6.9 mmol/L) identified 65 (90%) patients with diabetes (16 by FPG, 49 by 2h-PG) and required seven OGTTs per patient identified. Subjecting all patients with FPG <110 mg/dl (<6.1 mmol/L) to the OGTT identified 60 (83%) patients with diabetes (16 by FPG, 44 by 2h-PG) but required 14 OGTTs per patient.
The OGTT was paramount in finding most cases of undiagnosed diabetes before KTx. FPG but not HbA(1c) predicted a diabetic OGTT. We suggest that white KTx candidates without diabetes perform a pretransplantation OGTT when FPG is 92 to 125 mg/dl (5.1 to 6.9 mmol/L).</description><identifier>ISSN: 1555-9041</identifier><identifier>ISSN: 1555-905X</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.07501009</identifier><identifier>PMID: 20133490</identifier><language>eng</language><publisher>United States: Am Soc Nephrol</publisher><subject>Adult ; Aged ; Biomarkers - blood ; Blood Glucose - metabolism ; Cross-Sectional Studies ; Diabetes Mellitus - blood ; Diabetes Mellitus - diagnosis ; Diabetes Mellitus - ethnology ; Fasting - blood ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin - metabolism ; Humans ; Kidney Failure, Chronic - blood ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - ethnology ; Kidney Failure, Chronic - surgery ; Kidney Transplantation ; Male ; Middle Aged ; Norway ; Original ; Predictive Value of Tests ; ROC Curve ; White People</subject><ispartof>Clinical journal of the American Society of Nephrology, 2010-04, Vol.5 (4), p.616-622</ispartof><rights>Copyright © 2010 by the American Society of Nephrology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-838e0b31429f3d9f0c8ede8957cf011729e133d14589870931a1e5ec1e7d20133</citedby><cites>FETCH-LOGICAL-c407t-838e0b31429f3d9f0c8ede8957cf011729e133d14589870931a1e5ec1e7d20133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849698/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849698/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20133490$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bergrem, Henrik Andreas</creatorcontrib><creatorcontrib>Valderhaug, Tone Gretland</creatorcontrib><creatorcontrib>Hartmann, Anders</creatorcontrib><creatorcontrib>Hjelmesaeth, Joran</creatorcontrib><creatorcontrib>Leivestad, Torbjorn</creatorcontrib><creatorcontrib>Bergrem, Harald</creatorcontrib><creatorcontrib>Jenssen, Trond</creatorcontrib><title>Undiagnosed Diabetes in Kidney Transplant Candidates: A Case-Finding Strategy</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Guidelines recommend that candidates for kidney transplantation (KTx) who do not have diabetes perform a pretransplantation oral glucose tolerance test (OGTT) when fasting plasma glucose (FPG) is <110 mg/dl (<6.1 mmol/L); however, the OGTT is potentially costly and cumbersome. We studied the role of the OGTT for diagnosing diabetes and the accuracy of FPG and glycated hemoglobin (HbA(1c)) for predicting a diabetic OGTT before KTx.
In this cross-sectional study, 889 first single-kidney transplant candidates without diabetes, mainly white, performed an OGTT during the transplantation workup. Results were studied using receiver operating characteristic analysis.
Of 72 (8.1%) patients with undiagnosed diabetes, only 16 (22%) had a diabetic FPG (> or =126 mg/dl [> or =7.0 mmol/L]). In patients with a nondiabetic FPG, diabetes (2-hour plasma glucose [2h-PG] > or =200 mg/dl [> or =11.1 mmol/L]) was predicted by FPG but not by HbA(1c). Performing the OGTT in patients with FPG 92 to 125 mg/dl (5.1 to 6.9 mmol/L) identified 65 (90%) patients with diabetes (16 by FPG, 49 by 2h-PG) and required seven OGTTs per patient identified. Subjecting all patients with FPG <110 mg/dl (<6.1 mmol/L) to the OGTT identified 60 (83%) patients with diabetes (16 by FPG, 44 by 2h-PG) but required 14 OGTTs per patient.
The OGTT was paramount in finding most cases of undiagnosed diabetes before KTx. FPG but not HbA(1c) predicted a diabetic OGTT. We suggest that white KTx candidates without diabetes perform a pretransplantation OGTT when FPG is 92 to 125 mg/dl (5.1 to 6.9 mmol/L).</description><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - metabolism</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes Mellitus - blood</subject><subject>Diabetes Mellitus - diagnosis</subject><subject>Diabetes Mellitus - ethnology</subject><subject>Fasting - blood</subject><subject>Female</subject><subject>Glucose Tolerance Test</subject><subject>Glycated Hemoglobin - metabolism</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - blood</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - ethnology</subject><subject>Kidney Failure, Chronic - surgery</subject><subject>Kidney Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Norway</subject><subject>Original</subject><subject>Predictive Value of Tests</subject><subject>ROC Curve</subject><subject>White People</subject><issn>1555-9041</issn><issn>1555-905X</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kTtPwzAUhS0EglLYmFEmWEixYzuxGZBQeT8HQGKz3PgmdZU6JU5B_fcY-hAsTL6-99Px8T0I7RHcSxLCj_u3jz2ccUwwlmuoQzjnscT8bX1VM7KFtr0fYcwYTfgm2kowoZRJ3EEPr85YXbrag4nOrR5ACz6yLrqzxsEsemm085NKuzbq64AaHeYn0Vm4eYgvbWi5Mnpum9AvZztoo9CVh93F2UWvlxcv_ev4_unqpn92H-cMZ20sqAA8oIQlsqBGFjgXYEBInuUFJiRLJAR_hjAupMiwpEQT4JATyMyP9S46netOpoMxmBxcMFCpSWPHupmpWlv1d-LsUJX1h0oEk6kUQeBwIdDU71PwrRpbn0MVPgr11KuM0pSKVHyTR3Myb2rvGyhWrxCsvgNQIQC1DCDg-7-dreDlxgNwMAeGthx-2gaUH-uqCnii8pH2jiumUpL-A5K_4BdQO5s7</recordid><startdate>20100401</startdate><enddate>20100401</enddate><creator>Bergrem, Henrik Andreas</creator><creator>Valderhaug, Tone Gretland</creator><creator>Hartmann, Anders</creator><creator>Hjelmesaeth, Joran</creator><creator>Leivestad, Torbjorn</creator><creator>Bergrem, Harald</creator><creator>Jenssen, Trond</creator><general>Am Soc Nephrol</general><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100401</creationdate><title>Undiagnosed Diabetes in Kidney Transplant Candidates: A Case-Finding Strategy</title><author>Bergrem, Henrik Andreas ; 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however, the OGTT is potentially costly and cumbersome. We studied the role of the OGTT for diagnosing diabetes and the accuracy of FPG and glycated hemoglobin (HbA(1c)) for predicting a diabetic OGTT before KTx.
In this cross-sectional study, 889 first single-kidney transplant candidates without diabetes, mainly white, performed an OGTT during the transplantation workup. Results were studied using receiver operating characteristic analysis.
Of 72 (8.1%) patients with undiagnosed diabetes, only 16 (22%) had a diabetic FPG (> or =126 mg/dl [> or =7.0 mmol/L]). In patients with a nondiabetic FPG, diabetes (2-hour plasma glucose [2h-PG] > or =200 mg/dl [> or =11.1 mmol/L]) was predicted by FPG but not by HbA(1c). Performing the OGTT in patients with FPG 92 to 125 mg/dl (5.1 to 6.9 mmol/L) identified 65 (90%) patients with diabetes (16 by FPG, 49 by 2h-PG) and required seven OGTTs per patient identified. Subjecting all patients with FPG <110 mg/dl (<6.1 mmol/L) to the OGTT identified 60 (83%) patients with diabetes (16 by FPG, 44 by 2h-PG) but required 14 OGTTs per patient.
The OGTT was paramount in finding most cases of undiagnosed diabetes before KTx. FPG but not HbA(1c) predicted a diabetic OGTT. We suggest that white KTx candidates without diabetes perform a pretransplantation OGTT when FPG is 92 to 125 mg/dl (5.1 to 6.9 mmol/L).</abstract><cop>United States</cop><pub>Am Soc Nephrol</pub><pmid>20133490</pmid><doi>10.2215/CJN.07501009</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical journal of the American Society of Nephrology, 2010-04, Vol.5 (4), p.616-622 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Aged Biomarkers - blood Blood Glucose - metabolism Cross-Sectional Studies Diabetes Mellitus - blood Diabetes Mellitus - diagnosis Diabetes Mellitus - ethnology Fasting - blood Female Glucose Tolerance Test Glycated Hemoglobin - metabolism Humans Kidney Failure, Chronic - blood Kidney Failure, Chronic - complications Kidney Failure, Chronic - ethnology Kidney Failure, Chronic - surgery Kidney Transplantation Male Middle Aged Norway Original Predictive Value of Tests ROC Curve White People |
| title | Undiagnosed Diabetes in Kidney Transplant Candidates: A Case-Finding Strategy |
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