J Korean Soc Transplant.  2003 Jun;17(1):51-55.

Influence of Tacrolimus on Glucose Metabolism before and after Renal Transplantation

• Kang MK
• Han SY
• Park SB
• Kim HC

Abstract

PURPOSE
Posttransplant diabetes mellitus (PTDM) is one of the feared complications of the immunosuppressive agents following renal transplantation. Despite advances of immunosuppressive therapy, including the introduction of the steroid- sparing calcineurin inhibitors, cyclosporine and tacrolimus, the incidence rate remains greater than 10~30%.
METHODS
This prospective study investigated the influence of tacrolimus on glucose metabolism before and after transplantation for twenty patients without known glucose metabolism abnormalities.
RESULTS
The overall incidence of PTDM was 30% and was developed within 3 months after renal transplantation in majority of cases. During tacrolimus administration, fasting blood glucose increased from a median of 87.0 mg/dL to 103.5 mg/dL (P<0.05), and Insulin sensitivity decreased in 15 of 20 patients, from a median of 1.6 mg/dL/min to 1.2 mg/dL/min (P<0.05). Insulin secretion decreased from 1918.3 microUx min/mL to 1018.2micro Ux min/mL (P<0.05), whereas insulin resistance did not change.
CONCLUSION
These results indicate that diminished insulin secretion response to a glucose load rather than insulin resistance was proved as the main pathogenesis of PTDM in renal transplant recipients treated with tacrolimus. Higher tacrolimus trough level, older age, and higher weight were more frequently seen in the PTDM group than normal group, although the difference failed to reach statistical significance. Further prospective studies with a greater number of patients are needed to define the risk factor for PTDM.

Keyword

Posttransplant diabetes mellitus; Tacrolimus; Kidney transplantation

MeSH Terms

Blood Glucose
Calcineurin
Cyclosporine
Diabetes Mellitus
Fasting
Glucose*
Humans
Immunosuppressive Agents
Incidence
Insulin
Insulin Resistance
Kidney Transplantation*
Metabolism*
Prospective Studies
Risk Factors
Tacrolimus*
Transplantation
Blood Glucose
Calcineurin
Cyclosporine
Glucose
Immunosuppressive Agents
Insulin
Tacrolimus