Figure 1328

Post-transplantation diabetes mellitus (PTDM). PTDM complicates the course of treatment in 5% to 10% of patients on cyclosporine-based immunosuppressive therapy. It is more common in blacks and in patients with a family history of glucose intolerance. PTDM often reflects the substantial steroid-related weight gain that sometimes occurs after transplantation. The severity of PTDM can be attenuated by weight loss and corticosteroid withdrawal, although the latter may not be advisable owing to the risk of rejection. In a multicenter trial, PTDM occurred with greater frequency among patients treated with tacrolimus, particularly blacks. Although PTDM resolved over time in almost half of affected patients (as doses of tacrolimus and corticosteroids were gradually reduced), PTDM remained more common in patients receiving tacrolimus [25,42,43]. CyA—cyclosporine. (From Fujisawa USA [26]; with permission.)

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