Post-Renal Transplant Diabetes Mellitus in Korean Subjects: Superimposition of Transplant-Related Immunosuppressant Factors on Genetic and Type 2 Diabetic Risk Factors

• Published in: Diabetes & metabolism journal Vol. 36; no. 3; pp. 199 - 206
• Main Author: Lee, Hyun Chul
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Diabetes Association / Daehan Dangnyobyeong Hakoe 01.06.2012; Korean Diabetes Association; 대한당뇨병학회
• Subjects: Diabetes; Diabetes mellitus; Drugs; Glucose; Hepatitis; Hyperglycemia; Immunosuppressive agents; Insulin resistance; Kidney transplants; Metabolism; Pathophysiology; Polymorphism, genetic; Risk factors; Sulwon Lecture 2011; Transplantation; 내과학; Transplantation; Diabetes mellitus; Polymorphism, genetic; Immunosuppressive agents; Risk factors
• ISSN: 2233-6079; 2233-6087; 2233-6087
• DOI: 10.4093/dmj.2012.36.3.199

Postrenal transplantation diabetes mellitus (PTDM), or new-onset diabetes after organ transplantation, is an important chronic transplant-associated complication. Similar to type 2 diabetes, decreased insulin secretion and increased insulin resistance are important to the pathophysiologic mechanism behind the development of PTDM. However, β-cell dysfunction rather than insulin resistance seems to be a greater contributing factor in the development of PTDM. Increased age, family history of diabetes, ethnicity, genetic variation, obesity, and hepatitis C are partially accountable for an increased underlying risk of PTDM in renal allograft recipients. In addition, the use of and kinds of immunosuppressive agents are key transplant-associated risk factors. Recently, a number of genetic variants or polymorphisms susceptible to immunosuppressants have been reported to be associated with calcineurin inhibition-induced β-cell dysfunction. The identification of high risk factors of PTDM would help prevent PTDM and improve long-term patient outcomes by allowing for personalized immunosuppressant regimens and by managing cardiovascular risk factors.