The Diabetes Mellitus Incidence in Recipients of Renal Allograft in Al-Nassiyria City

  • Methaq A.M. Hussein Department of Internal Medicine, College of Medicine, University of Thi-Qar.


BACKGROUND:    Immunosuppressive drugs is the main cause of   Post-transplant diabetes mellitus, which consider as one of the highly commonest transplant complications. Aim: To assess the Post-transplant diabetes mellitus incidence and determine the other factors which may play a role in this complication development. Method:   105 non-DM study population included in this study transplanted renal allograft, since 1999. Post-transplant diabetes mellitus was identified by the requirement of the hypoglycemic drug which started after transplantation by a range of more than one month. All patients after transplantation received prednisone and cyclosporine and no one received tacrolimus. Results:      At 1st, 3rd, 5th, and 10th  years  follow up after transplantation, five, eight, eleven and lastly nineteen percent developing  Post-transplant diabetes mellitus., the correlated  variables was determined as independent variables for the  rapid increment  in the Post-transplant diabetes mellitus numbers, which, higher BMI- before transplant,  age  of recipient the  younger  than 45 years significantly  differ from older age with  P < 0.0001 Conclusions:    Post-transplant diabetes mellitus risk continuously increases with post-transplant time. Transplanted patients show increment in Post-transplant diabetes mellitus incidence whose recipients characteristics changes is the full explanation of this matter. The assumption of a cause of this increment is due to the introduction of better absorbed CsA formulations, which resulted in higher diabetogenic drug cumulative exposure in addition to other factors.


Schweitzer, EJ, Matas, AJ & Gillingham, KJ, et al: Causes of renal allograft loss: Progress in the 1980s, challenges for the 1990s. Ann Surg 1991214: 679–688,

The Tricontinental Mycophenolate Mofetil Renal Transplantation Study Group: A blinded, randomized clinical trial of Mycophenolate Mofetil for the prevention of acute rejection in cadaveric renal transplantation. Transplantation 199661: 1029–1037,

Hariharan, S, Johnson, CP & Breshnahan, BA, et al: Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med 2000342: 605–612Cosio, FG, Alamir, A & Yim, S, et al: Patient survival after renal transplantation. I. The impact of dialysis pre-transplant. Kidney Int 199853: 767–772,

Ojo, AO, Hanson, JA & Wolfe, RA, et al: Long-term survival in renal transplant recipients with graft function. Kidney Int 200057: 307–313, 10.1046/j.1523-1755.2000.00816.x

USRDS: United States Renal Data System 1996 annual data report. Am J Kidney Dis 199628: S1–S152,

Kasiske, BL: Risk factors for cardiovascular disease after renal transplantation. Miner Electrolyte Metab 199319: 186–195, |

Cosio, FG, Falkenhain, ME & Pesavento, TE, et al: Patient survival after renal transplantation. II. The impact of smoking. Clin Transplant 199913: 336–341 |

Foley, RN, Parfrey, PS & Sarnak, MJ: Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 199832(Suppl 3):S112–S119, |

Osei, K: Insulin resistance and systemic hypertension. Am J Cardiol 199984: 33J–36J, |

Reaven, GM, Lithell, H & Landsberg, L: Hypertension and associated metabolic abnormalities: The role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996334: 374–381, |

Weir, M & Fink, J: Risk for posttransplant diabetes mellitus with current immunosuppressive medications. Am J Kidney Dis 199934: 1–13, |

Pirsch, JD, Miller, J & Deierhoi, MH, et al: A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. Transplantation 199763: 977–983, |

Ritz, E, Rychlik, I & Locatelli, F, et al: End-stage renal failure in type 2 diabetes: A medical catastrophe of worldwide dimensions. Am J Kidney Dis 199934: 795–808 |

Osei, K, Gaillard, T & Schuster, DP: Pathogenetic mechanisms of impaired glucose tolerance and type II diabetes in African-Americans. Diabetes Care 199720: 396–404 |

Osei, K & Schuster, DP: Ethnic differences in secretion, sensitivity, and hepatic extraction of insulin in black and white Americans. Diabet Med 199411: 755–762 |

Neilsen, JH, Mandrup-Poulsen, T & Nerup, J: Direct effects of cyclosporine A on human pancreatic beta-cells. Diabetes 198635: 1049–1052, Gillison, SL, Bartlett, ST & Curry, DL: Inhibition by cyclosporine of insulin secretion-A beta cell-specific alteration of islet tissue function. Transplantation 199152: 890–895,