New-onset diabetes mellitus remains a common complication of liver transplantation.
Dr Faouzi Saliba and colleagues from France studied incidence and risk factors in 211 patients who had undergone a primary liver transplantation between 6 and 24 months previously.
The research team conducted a cross-sectional and retrospective multicenter study.
The researchers collected on consecutive patients at a single routine post-liver transplantation consultation.
|The overall incidence of new-onset diabetes mellitus was 23%|
Demographic details, immunosuppressive regimens, familial and personal histories, hepatitis status, and cardiovascular risk were analyzed.
The team assessed those with newly developed diabetes, according to American Diabetes Association/World Health Organization criteria.
The researchers found that the overall incidence of new-onset diabetes mellitus was 23%.
The incidence in tacrolimus-treated patients was 24%, and 17% in cyclosporine-treated patients.
A total of 81% of the cases were diagnosed within 3 months of liver transplantation.
Among Hepatitis C virus-infected patients, new-onset diabetes mellitus incidence was 42%.
However, the team observed that among those patients negative for Hepatitis C virus, the incidence was only 19%.
With tacrolimus, the incidence of new-onset diabetes mellitus in the Hepatitis C virus positive patients was higher than in the Hepatitis C virus negative patients.
Only 17% of the Hepatitis C virus positive patients developed new-onset diabetes mellitus on cyclosporine.
The researchers found that impaired fasting glucose ther independent pretransplantation risk factors for new-onset diabetes mellitus.
A maximum lifetime body-mass index over 25 kg/m2 was an independent pretransplantation risk factor for new-onset diabetes mellitus.
Dr Saliba's team concludes, “Emergence of new-onset diabetes mellitus after liver transplantation is related to risk factors that can be detected prior to the graft.”
“These risk factors include maximum lifetime body-mass index, impaired fasting glucose, and Hepatitis C virus status.”
“Tacrolimus induced a higher incidence of new-onset diabetes mellitus in the Hepatitis C virus positive compared to the Hepatitis C virus negative patients.”
“The treatment should be tailored to the patient's risk especially in case of Hepatitis C virus infection.”