Can new-onset diabetes after kidney transplant be prevented?
Can new-onset diabetes after kidney transplant be prevented?
复制标题
DOI：
10.2337/dc12-2067
复制
发表时间：
2013-05
期刊：
影响因子：
16.2
通讯作者：
Knowler WC
中科院分区：
文献类型：
--
作者：
Chakkera HA;Weil EJ;Pham PT;Pomeroy J;Knowler WC
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 β-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 β-cells during the immediate postoperative period, may lower the incidence of NODAT.
登录
查看更多内容
影响因子：
19.6
作者：
Cosio, FG;Pesavento, TE;Ferguson, RM
通讯作者：
Ferguson, RM
影响因子：
6.2
作者：
Bayer ND;Cochetti PT;Anil Kumar MS;Teal V;Huan Y;Doria C;Bloom RD;Rosas SE
通讯作者：
Rosas SE
影响因子：
15.9
作者：
BERGMAN, RN;PHILLIPS, LS;COBELLI, C
通讯作者：
COBELLI, C
影响因子：
37.8
作者：
Festa, A;D'Agostino, R;Haffner, SM
通讯作者：
Haffner, SM
影响因子：
13.6
作者：
Johnston, Olwyn;Rose, Caren L.;Gill, John S.
通讯作者：
Gill, John S.