Approach to the patient with new-onset diabetes after transplant (NODAT).

摘要: New-onset diabetes after transplantation (NODAT) refers to the occurrence of in previously nondiabetic persons organ transplantation. The incidence rates NODAT vary by transplanted and posttransplant interval. estimated at 12 months are 20-50% for kidney transplants, 9-21% liver approximately 20% lung transplants. is associated with increased risks graft rejection, infection, cardiovascular disease, death. Besides traditional risk factors type 2 (age, family history, obesity, ethnicity), exposure immunosuppressive agents often precedes NODAT. Identification through pretransplant screening desirable, as prompt diagnosis appropriate treatment. consistent responds usual antidiabetes agents. However, severe hyperglycemia during early period may necessitate use iv insulin infusion. Also, high-dose glucocorticoid therapy induction immunosuppression (or treatment acute rejection) require glycemic control. After hospital discharge, close monitoring blood glucose first month every 3 year recommended. Consideration should be given drug toxicities or interactions when prescribing patient. In addition hyperglycemia, control comorbidities such dyslipidemia hypertension needs optimized. Future areas investigation include development regimens minimal diabetogenic effects, determination role on survival, interventions primary prevention