New onset diabetes mellitus after renal transplantation: impact of immunosuppresssive and antihypertensive therapy

ABSTRACT

The purpose of the present study was to assess the influence of immunosuppresssive and antihypertensive therapy in the diabetic state after renal transplantation especially impaired fasting glucose [IGF], and impaired glucose tolerance [IGT]. A total of 67 consecutive renal transplant recipients without previously known diabetes underwent a 75gm oral glucose tolerance test [OGTT] 3 months after renal transplantation. BMI, daily prednisolone dose, creatinine clearance, hypertension, number of antihypertensive agents and the use of diuretics or 3 blockers were POSITIVELY associated with, impaired glucose tolerance [IGT], namely impaired fasting glucose [IGF], and abnormal glucose tolerance [ACT] [p<0.05]. After multiple regression analysis, BMI [p<0.001], daily prednisolone dose [p<0.001], cytomegalovirus infection [p<0.03], and triglycerides [p<0.034], were shown to be independent predictors of posttransplant ACT. Increasing daily prednisolone dose is an independent predictor of impaired fasting glucose after renal transplantation. Hypertension and the use of diuretics and beta blockers may also deteriorate glucose tolerance [CT] in this group of patients