Indian Journal of Endocrinology and Metabolism

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 23  |  Issue : 3  |  Page : 273--277

Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study


Partha Sarathi Choudhury1, Pradip Mukhopadhyay2, Arpita Roychowdhary3, Subhankar Chowdhury2, Sujoy Ghosh2 
1 Department of Endocrinology, Medical College, Kolkata, West Bengal, India
2 Department of Endocrinology, IPGME&R, Kolkata, West Bengal, India
3 Department of Nephrology, IPGME&R, Kolkata, West Bengal, India

Correspondence Address:
Pradip Mukhopadhyay
Associate Professor, Department of Endocrinology, IPGME&R, Kolkata - 700 020, West Bengal
India

Objective: New-onset diabetes after transplantation (NODAT) develops frequently after renal transplant. The study aims at the prevalence of NODAT , predictors for developing it and therapeutic glycemic responses in NODAT. Materials and Methods: Consecutive renal transplant recipients excluding Diabetic Kidney Disease (DKD) or pretransplant diabetes were evaluated. Forty-three out of 250 persons were found to have NODAT. Ninety age-matched transplant recipients from the rest were recruited as control. Fasting blood sugar (FBS), HbA1c, lipid profile, and trough tacrolimus level (T0) were examined in all. HOMA IR C-peptide and HOMA-beta C-peptide were calculated. Results: Prevalence of NODAT in renal transplant recipients was 17.2% (43/250). Twenty-four (55.8%) developed early NODAT (<1 year) and 19 (44.2%) developed late NODAT (>1 year). Significantly higher pretransplant body mass index (BMI) (kg/m2) (P < 0.001), waist circumference (WC) (cm) (P < 0.001), pretransplant cholesterol (mg%) (P = 0.04), triglyceride (mg%) (P < 0.001), and FBS (mg%) (P < 0.001) were found in NODAT compared with non-NODAT. Trough tacrolimus (ng/mL) was found to be higher in NODAT (10.2 vs. 5.37, P < 0.001). Though HOMA IR was not found to be different between groups, HOMA-beta C-peptide was low in NODAT compared with non-NODAT (P = 0.03). Predictors of NODAT were WC [odds ratio (OR) = 01.15] and trough tacrolimus level (OR = 1.316). Best cut-off of WC for predicting NODAT was 87.5 cm for male and 83.5 cm for female. Best cut-off of T0 was 8.5 ng/mL. In NODAT, 9.3% were treated by lifestyle modification, 67.4% by oral hypoglycemic agents, 11.6% by insulin, and 11.6% by combined insulin and oral antidiabetic agents with HbA1c <7%. Conclusion: NODAT in renal transplant recipients is more common in those with higher pretransplant BMI, WC, pretransplant total cholesterol, triglyceride, and FBS. Beta-cell secretory defect is more relevant as etiological factor rather than insulin resistance. Higher WC and trough tacrolimus level above 8.5 ng/mL may be important factors for predicting NODAT.


How to cite this article:
Choudhury PS, Mukhopadhyay P, Roychowdhary A, Chowdhury S, Ghosh S. Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study.Indian J Endocr Metab 2019;23:273-277


How to cite this URL:
Choudhury PS, Mukhopadhyay P, Roychowdhary A, Chowdhury S, Ghosh S. Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: An observational study. Indian J Endocr Metab [serial online] 2019 [cited 2019 Aug 21 ];23:273-277
Available from: http://www.ijem.in/article.asp?issn=2230-8210;year=2019;volume=23;issue=3;spage=273;epage=277;aulast=Choudhury;type=0