Abstract
Restoration of renal function may ameliorate uremia induced insulin resistance. Therefore it seems a paradox that new-onset posttransplantation diabetes mellitus (PTDM) is a frequently observed complication after renal transplantation. The incidence varies between 2 and 50% depending on the population under study, criteria for the diagnosis of diabetes and the time of follow up. This review addresses recent findings on transplant specific risk factors and pathogenesis of PTDM after solid organ transplantation, and we focus on the following issues: 1. The relative impact of insulin resistance and insulinopenia in the pathogenesis of PTDM. 2. The role of immunosuppressive drugs with special emphasis on calcineurin inhibitors (cyclosporine A, tacrolimus) and steroids. 3. The possible roles of cytomegalovirus and hepatitis C infections. Conclusions: New-onset PTDM is characterized by a variety of clinical manifestations, ranging from predominantly insulin resistance which can be handled with lifestyle intervention, to β-cell failure requiring insulin treatment. The etiology is multi-factorial, but diabetogenic immunosuppressive drugs are of major importance. Future studies should therefore address the effects of different immunosuppressive regimens on the incidence of PTDM. In addition, the impact of cytomegalovirus infection and hepatitis C on PTDM needs further evaluation.
Keywords: diabetes mellitus, transplantation, insulin, immunosuppression, steroids, virus infection
Current Diabetes Reviews
Title: New-Onset Posttransplantation Diabetes Mellitus: Insulin Resistance or Insulinopenia? Impact of Immunosuppressive Drugs, Cytomegalovirus and Hepatitis C Virus Infection
Volume: 1 Issue: 1
Author(s): Joran Hjelmesaeth, Anders Asberg, Fredrik Muller, Anders Hartmann and Trond Jenssen
Affiliation:
Keywords: diabetes mellitus, transplantation, insulin, immunosuppression, steroids, virus infection
Abstract: Restoration of renal function may ameliorate uremia induced insulin resistance. Therefore it seems a paradox that new-onset posttransplantation diabetes mellitus (PTDM) is a frequently observed complication after renal transplantation. The incidence varies between 2 and 50% depending on the population under study, criteria for the diagnosis of diabetes and the time of follow up. This review addresses recent findings on transplant specific risk factors and pathogenesis of PTDM after solid organ transplantation, and we focus on the following issues: 1. The relative impact of insulin resistance and insulinopenia in the pathogenesis of PTDM. 2. The role of immunosuppressive drugs with special emphasis on calcineurin inhibitors (cyclosporine A, tacrolimus) and steroids. 3. The possible roles of cytomegalovirus and hepatitis C infections. Conclusions: New-onset PTDM is characterized by a variety of clinical manifestations, ranging from predominantly insulin resistance which can be handled with lifestyle intervention, to β-cell failure requiring insulin treatment. The etiology is multi-factorial, but diabetogenic immunosuppressive drugs are of major importance. Future studies should therefore address the effects of different immunosuppressive regimens on the incidence of PTDM. In addition, the impact of cytomegalovirus infection and hepatitis C on PTDM needs further evaluation.
Export Options
About this article
Cite this article as:
Hjelmesaeth Joran, Asberg Anders, Muller Fredrik, Hartmann Anders and Jenssen Trond, New-Onset Posttransplantation Diabetes Mellitus: Insulin Resistance or Insulinopenia? Impact of Immunosuppressive Drugs, Cytomegalovirus and Hepatitis C Virus Infection, Current Diabetes Reviews 2005; 1 (1) . https://dx.doi.org/10.2174/1573399052952604
DOI https://dx.doi.org/10.2174/1573399052952604 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Modulation of P2 Receptors on Pancreatic β-cells by Agonists and Antagonists: A Molecular Target for Type 2 Diabetes Treatment
Current Diabetes Reviews Bone Disease in Diabetes
Current Diabetes Reviews Dual Inhibition of DPP-4 and Cholinesterase Enzymes by the Phytoconstituents of the Ethanolic Extract of Prosopis cineraria Pods: Therapeutic Implications for the Treatment of Diabetes-associated Neurological Impairments
Current Alzheimer Research Endothelial Function and Pathogenesis of Endothelial Dysfunction
Current Immunology Reviews (Discontinued) Microvascular Endothelial Dysfunction in Obesity and Hypertension
Current Pharmaceutical Design Novel Oral Anticoagulants in the Treatment of Acute Coronary Syndromes: Is there any Room for New Anticoagulants?
Current Clinical Pharmacology Epidemiology of Septic Acute Kidney Injury
Current Drug Targets EBI2, GPR18, and GPR17 – Three Structurally Related but Biologically Distinct 7TM Receptors
Current Topics in Medicinal Chemistry Therapies Targeting Innate Immunity for Fighting Inflammation in Atherosclerosis
Current Pharmaceutical Design Targeting IL-17 and IL-23 in Immune Mediated Renal Disease
Current Medicinal Chemistry Vitamin D Metabolites and/or Analogs: Which D for Which Patient?
Current Vascular Pharmacology Olmesartan Reduces Pentosidine Production and Ameliorates Fragility of Bone in Ovariectomized Fructose-Fed Rats
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Restoring the Dysfunctional Endothelium
Current Pharmaceutical Design Taxation as Prevention and as a Treatment for Obesity: The Case of Sugar-Sweetened Beverages
Current Pharmaceutical Design Exploring AT2R and its Polymorphism in Different Diseases: An Approach to Develop AT2R as a Drug Target beyond Hypertension
Current Drug Targets Data-driven Approach to Detect and Predict Adverse Drug Reactions
Current Pharmaceutical Design The Use of Biomarkers for Assessing HAART-Associated Renal Toxicity in HIV-Infected Patients
Current HIV Research Editorial [Hot Topic: Plasminogen Activator Inhibitor-1 (Guest Editor: Daniel A. Lawrence)]
Current Drug Targets Medical Treatment of Peripheral Arterial Disease: Current Concepts and Future Options
Vascular Disease Prevention (Discontinued) Molecular Mechanisms of Diabetic Nephropathy and Its Therapeutic Intervention
Current Drug Targets