Can New-Onset Diabetes After Kidney Transplant Be Prevented?

被引:83
作者
Chakkera, Harini A. [1 ]
Weil, E. Jennifer [2 ]
Phuong-Thu Pham [3 ,4 ]
Pomeroy, Jeremy [2 ]
Knowler, William C. [2 ]
机构
[1] Mayo Clin, Div Transplantat, Phoenix, AZ USA
[2] NIDDKD, Diabet Epidemiol & Clin Res Sect, NIH, Phoenix, AZ USA
[3] Univ Calif Los Angeles, Dept Internal Med, Hlth Syst, Los Angeles, CA USA
[4] Univ Calif Los Angeles, Dept Nephrol, Hlth Syst, Los Angeles, CA USA
关键词
IMPAIRED GLUCOSE-TOLERANCE; BODY-MASS INDEX; LIFE-STYLE INTERVENTION; HEMODIALYSIS-PATIENTS; INSULIN SENSITIVITY; PHYSICAL-ACTIVITY; FASTING GLUCOSE; MELLITUS; HYPERGLYCEMIA; RISK;
D O I
10.2337/dc12-2067
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Because the negative consequences of new-onset diabetes mellitus after transplantation (NODAT) diminish the significant gains of kidney transplantation, it is imperative to develop clinical interventions to reduce the incidence of NODAT. In this review, we discuss whether intensive lifestyle interventions that delay or prevent type 2 diabetes mellitus may decrease the incidence of NODAT. We examine the literature pertaining to incidence and timing of onset of NODAT, as well as the risk factors and pathophysiology that NODAT shares with type 2 diabetes mellitus, namely pathways related to increased insulin resistance and decreased insulin secretion. Our central hypothesis is that NODAT results from the same metabolic risk factors that underlie type 2 diabetes mellitus. These risk factors are altered and enhanced by transplantation, "tipping" some transplant recipients with seemingly normal glucose homeostasis before transplant toward the development of NODAT. We describe the diabetogenic properties of transplant immunosuppressive drugs. We describe novel methods of prevention that are being explored, including resting the pancreatic beta-cells by administration of basal insulin during the period immediately after transplant. On the basis of the current evidence, we propose that intensive lifestyle modification, adapted for individuals with chronic kidney disease or end-stage renal disease, as well as resting pancreatic beta-cells during the immediate postoperative period, may lower the incidence of NODAT.
引用
收藏
页码:1406 / 1412
页数:7
相关论文
共 60 条
[41]   Higher recipient body mass index is associated with post-transplant delayed kidney graft function [J].
Molnar, Miklos Z. ;
Kovesdy, Csaba P. ;
Mucsi, Istvan ;
Bunnapradist, Suphamai ;
Streja, Elani ;
Krishnan, Mahesh ;
Kalantar-Zadeh, Kamyar .
KIDNEY INTERNATIONAL, 2011, 80 (02) :219-225
[42]   Early Basal Insulin Therapy Decreases New-Onset Diabetes after Renal Transplantation [J].
Necking, Manfred ;
Haidinger, Michael ;
Doeller, Dominik ;
Werzowa, Johannes ;
Tura, Andrea ;
Zhang, Jinyao ;
Tekoglu, Hilal ;
Pleiner, Johannes ;
Wrba, Thomas ;
Rasoul-Rockenschaub, Susanne ;
Muehlbacher, Ferdinand ;
Schmaldienst, Sabine ;
Druml, Wilfred ;
Hoerl, Walter H. ;
Krebs, Michael ;
Wolzt, Michael ;
Pacini, Giovanni ;
Port, Friedrich K. ;
Saeemann, Marcus D. .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2012, 23 (04) :739-749
[43]  
Painter P, 2011, NEPHROL NURS J, V38, P139
[44]   Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance - The Da Qing IGT and diabetes study [J].
Pan, XR ;
Li, GW ;
Hu, YH ;
Wang, JX ;
Yang, WY ;
An, ZX ;
Hu, ZX ;
Lin, J ;
Xiao, JZ ;
Cao, HB ;
Liu, PA ;
Jiang, XG ;
Jiang, YY ;
Wang, JP ;
Zheng, H ;
Zhang, H ;
Bennett, PH ;
Howard, BV .
DIABETES CARE, 1997, 20 (04) :537-544
[45]   THE RENAL METABOLISM OF INSULIN [J].
RABKIN, R ;
RYAN, MP ;
DUCKWORTH, WC .
DIABETOLOGIA, 1984, 27 (03) :351-357
[46]   The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1) [J].
Ramachandran, A ;
Snehalatha, C ;
Mary, S ;
Mukesh, B ;
Bhaskar, AD ;
Vijay, V .
DIABETOLOGIA, 2006, 49 (02) :289-297
[47]   Prediction at First Year of Incident New-Onset Diabetes After Kidney Transplantation by Risk Prediction Models [J].
Rodrigo, Emilio ;
Santos, Lidia ;
Pinera, Celestino ;
Ruiz San Millan, Juan Carlos ;
Estrella Quintela, Maria ;
Toyos, Carmen ;
Allende, Natalia ;
Gomez-Alamillo, Carlos ;
Arias, Manuel .
DIABETES CARE, 2012, 35 (03) :471-473
[48]   Lifestyle Modification and Prevention of Type 2 Diabetes in Overweight Japanese With Impaired Fasting Glucose Levels A Randomized Controlled Trial [J].
Saito, Toshikazu ;
Watanabe, Makoto ;
Nishida, Junko ;
Izumi, Tomono ;
Omura, Masao ;
Takagi, Toshikazu ;
Fukunaga, Ryuzo ;
Bandai, Yasutsugu ;
Tajima, Naoko ;
Nakamura, Yosikazu ;
Ito, Masaharu .
ARCHIVES OF INTERNAL MEDICINE, 2011, 171 (15) :1352-1360
[49]   Obesity and survival on dialysis [J].
Salahudeen, AK .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2003, 41 (05) :925-932
[50]   Complications associated with new-onset diabetes after kidney transplantation [J].
Sharif, Adnan ;
Baboolal, Keshwar .
NATURE REVIEWS NEPHROLOGY, 2012, 8 (01) :34-42