Post-transplantation diabetes mellitus.

摘要: Post-transplantation diabetes mellitus (PTDM) is defined as sustained hyperglycemia developing in any patient without history of before transplantation, that meets the current diagnostic criteria by American Diabetes Association or World Health Organization. Several risk factors have been identified: age, nonwhite ethnicity, and glucocorticoid therapy for rejection chronic immunosuppression with cyclosporine especially tacrolimus. The pathophysiology this condition resembles type 2 mellitus: pretransplantation end-stage liver/renal heart disease are insulin-resistant states, after glucocorticoids induce further peripheral insulin insensitivity. "second hit" appears to be an acquired (yet reversible) secretion defect resulting from calcineurin inhibitors An international panel experts has recently published proceeding a Consensus Conference proposing strategies screening, prevention management PTDM. Future directions include pre- post-transplantation glucose load testing high-risk individuals pharmacological agents decrease resistance preserve β-cell function