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Post-transplant Diabetes: Current Understandings

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Dr Debmalya Sanyal, Kolkata    19 November 2018

Transplant patients may have pre-existing diabetes, develop post-transplant diabetes or transient post-op hyperglycemia. Post-transplant diabetes mellitus (PTDM) is common. It is associated with decreased patient and graft survival and increased CVD and infection. Risk stratification and intervention are required to minimize risk. Insulin secretion and sensitivity are impaired and need multifaceted management. Immunosuppressive medications may impair kidney function and dose adjustments of diabetes medications are often needed for this. Individualize glycemic targets according to prevalent comorbidities. There may be increased CVD risk with poorly tolerated hypoglycemia. DPP-4 inhibitors and metformin can be given.

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