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
-
The Role of Glycoprotein IIb/IIIa Inhibitors- A Promise Not Kept?
Current Cardiology Reviews Present Insights on Cardiomyopathy in Diabetic Patients
Current Diabetes Reviews Diabetes Mellitus as a Risk Factor for Cancer: Stress or Viral Etiology?
Infectious Disorders - Drug Targets Role of Platelet Function Testing in Clinical Practice: Current Concepts and Future Perspectives
Current Drug Targets New Perspectives of HIV/AIDS Therapy Study
Recent Patents on Anti-Infective Drug Discovery Endothelial Expression of MHC Class II Molecules in Autoimmune Disease
Current Pharmaceutical Design Atherosclerosis-Related Functions of C-Reactive Protein
Cardiovascular & Hematological Disorders-Drug Targets Therapeutic Effects of Renal Denervation on Renal Failure
Current Neurovascular Research Rhodanine as a Privileged Scaffold in Drug Discovery
Current Medicinal Chemistry Long Noncoding RNAs as Diagnostic and Therapeutic Targets for Ischemic Stroke
Current Pharmaceutical Design Atypical Presentation Of Anti-Retroviral Therapy Induced Lactic Acidosis as Acute Right Ventricular Failure And Severe Pulmonary Hypertension
New Emirates Medical Journal Peroxisome Proliferator-Activated Receptor-γ: Master Regulator of Adipogenesis and Obesity
Current Stem Cell Research & Therapy Editorial [Hot Topic: Adrenergic Receptors as Novel Targets for Cancer Therapy (Guest Editors: D.G. Powe and F. Entschladen)]
Current Cancer Therapy Reviews Peripheral Artery Disease in Diabetes Mellitus: Focus on Novel Treatment Options
Current Pharmaceutical Design Results of Controlled Clinical Trials Comparing “Guideline Exposed” and “Guideline Naive” Physicians in the Treatment of Depression, Hypertension,and Diabetes: What can be Learned?
Current Psychiatry Reviews Selective Divalent Copper Chelation for the Treatment of Diabetes Mellitus
Current Medicinal Chemistry Challenges for the Treatment of Diabetes Mellitus
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Improvement in Hypertension Management with Pharmacological and Non- Pharmacological Approaches: Current Perspectives
Current Pharmaceutical Design WNT Signaling in Stem Cell Biology and Regenerative Medicine
Current Drug Targets Future Therapeutic Directions: New Medications and Insulin Delivery in a Changing World for Effective Diabetes Management
Current Drug Discovery Technologies