Impaired Fastig Glucose According to Different Diagnostic Criteria in Kidney Transplanted Patients

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Abstract

Introduction

The alteration in carbohydrates metabolism is frequently observed after kidney transplantation. New onset diabetes after transplant (NODAT) has been extensively studied, although there are no reports of the characteristics and frequency of the impaired fasting glucose (IFG).

Materials and Methods

We evaluated all patients who had undergone transplant in our unit in the last fifteen years with more than one year of follow-up. We considered that a patient had impaired fasting glucose when he met the criteria of the ADA and/or WHO, and presented less than 20 mg of meprednisone. All values obtained during the hospitalization or up to one month after the steroid pulse treatment were excluded. We considered average values and standard deviation of the variables.

Results

We studied 481 patients from a total of 596. Only 117 patients (24.32%) presented normal glycemia values during the tracking (6.1 years on average). Of the remaining 364 patients, 150 met the ADA criteria and 111 met the WHO criteria. A total of 103 patients presented NODAT (prevalence of 21.41%). The average time between transplant and IFG was 25.52 and 28.66 months depending on the considered criteria. 11.22% (n=54) met the diabetes criteria without having gone through IFG, while another 10.18% (n=49) of the patients who had IFG progressed to diabetes. Diabetic patients were significantly older than those who presented IFG, and the latter were older than those who didn’t present alterations in glycemia. We observed no differences concerning mortality, dialysis re-entry, time on dialysis or hepatitis C prevalence among groups.

Conclusion

IFG is very frequent in transplanted patients. Although not every patient’s condition evolved into NODAT, this is a risk group for cardiovascular disease, thus precautionary measures should be taken. The number of individuals included may have contributed to the lack of significant differences between populations.

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