Diabetes Metab J.  2012 Jun;36(3):199-206. 10.4093/dmj.2012.36.3.199.

Post-Renal Transplant Diabetes Mellitus in Korean Subjects: Superimposition of Transplant-Related Immunosuppressant Factors on Genetic and Type 2 Diabetic Risk Factors

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. endohclee@yuhs.ac

Abstract

Postrenal transplantation diabetes mellitus (PTDM), or new-onset diabetes after organ transplantation, is an important chronic transplant-associated complication. Similar to type 2 diabetes, decreased insulin secretion and increased insulin resistance are important to the pathophysiologic mechanism behind the development of PTDM. However, beta-cell dysfunction rather than insulin resistance seems to be a greater contributing factor in the development of PTDM. Increased age, family history of diabetes, ethnicity, genetic variation, obesity, and hepatitis C are partially accountable for an increased underlying risk of PTDM in renal allograft recipients. In addition, the use of and kinds of immunosuppressive agents are key transplant-associated risk factors. Recently, a number of genetic variants or polymorphisms susceptible to immunosuppressants have been reported to be associated with calcineurin inhibition-induced beta-cell dysfunction. The identification of high risk factors of PTDM would help prevent PTDM and improve long-term patient outcomes by allowing for personalized immunosuppressant regimens and by managing cardiovascular risk factors.

Keyword

Diabetes mellitus; Immunosuppressive agents; Polymorphism, genetic; Risk factors; Transplantation

MeSH Terms

Calcineurin
Diabetes Mellitus
Genetic Variation
Hepatitis C
Humans
Immunosuppressive Agents
Insulin
Insulin Resistance
Obesity
Organ Transplantation
Polymorphism, Genetic
Risk Factors
Transplantation, Homologous
Transplants
Calcineurin
Immunosuppressive Agents
Insulin
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