Post-transplantation diabetes in kidney transplant recipients: an update on management and prevention

摘要: Post-transplantation diabetes mellitus (PTDM) may severely impact both short- and long-term outcomes of kidney transplant recipients in terms graft patient survival. However, PTDM often goes undiagnosed is underestimated or poorly managed. A diagnosis should be delayed until the on stable maintenance doses immunosuppressive drugs, with function absence acute infections. Risk factors for assessed during pre-transplant evaluation period, order to reduce likelihood developing diabetes. The oral glucose tolerance test considered as gold standard diagnosing PTDM, whereas HbA1c not reliable first months after transplantation. Glycaemic targets individualised, comorbidities such dyslipidaemia hypertension treated drugs that have least possible metabolism, at do interact immunosuppressants. While insulin preferred agent treating inpatient hyperglycaemia immediate post-transplantation little evidence available guide therapeutic choices management PTDM. Metformin incretins offer some advantage over other glucose-lowering agents, particularly respect risk hypoglycaemia weight gain. Tailoring regimens help, although good prioritised prevention/treatment aim this narrative review provide an overview prevention a focus options.