Introduction:
Post-transplant diabetes mellitus (PTDM) is a significant complication following organ transplantation, contributing to increased morbidity and mortality. Previous research has identified several risk factors associated with the development of PTDM, including older age, higher body mass index (BMI), use of corticosteroids, and the presence of pre-existing impaired glucose tolerance. Additionally, gender differences have been noted, with female patients sometimes exhibiting a higher susceptibility to PTDM. Despite these known factors, the specific contributions of glycemia, body weight, and the nuances of steroid therapy on PTDM development remain areas of ongoing investigation. In this study, we analyze these factors within a cohort of patients who underwent transplantation between 2021 and 2024 at a single medical department, where they received comprehensive post-transplant care, education, and thorough qualification prior to kidney transplantation.
Methods:
A retrospective cohort study was conducted, including 47 patients who underwent organ transplantation at a single medical center between 2021 and 2024. The cohort consisted of 28 females (59.6%) and 19 males (40.4%). The primary outcome was the occurrence of PTDM, defined as new-onset diabetes post-transplant. Logistic regression analysis was performed to assess the impact of glycemia (mg/dL), body weight (kg), BMI, gender, and post-transplant steroid therapy on the development of PTDM. Patients were offered the option of continuous glucose monitoring (CGM), and those who developed PTDM used CGM initially; however, CGM was no longer required after six months due to successful education, lifestyle changes, and adjustments to immunosuppressive treatment.
Results:
The logistic regression model indicated that gender (p=0.029) and body weight (p=0.020) were significant predictors of PTDM. Female patients were more likely to develop PTDM compared to males (OR=2.60, 95% CI: 0.27-4.93). Additionally, higher body weight was associated with an increased risk of PTDM (OR=0.21, 95% CI: 0.03-0.39). While glycemia and BMI showed trends towards influencing PTDM, they did not reach statistical significance (p>0.05). The effect of steroid therapy was not statistically significant (p=0.999), likely due to the rarity of steroid pulses, reflecting the low incidence of acute graft rejection in this cohort. All patients with PTDM who initially used CGM no longer required it after six months, owing to the effectiveness of the education program, lifestyle modifications, and careful adjustment of immunosuppressive therapy.
Conclusions:
This study suggests that gender and body weight are significant predictors of PTDM in transplant recipients, with females and those with higher body weight being at greater risk. The findings underscore the importance of comprehensive post-transplant care, including patient education and lifestyle interventions. The successful discontinuation of CGM in PTDM patients after six months highlights the effectiveness of this approach. Further studies with larger sample sizes are needed to explore the role of glycemia and BMI in PTDM risk.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.