Post-transplant diabetes mellitus (PTDM) is one of the most significant adverse complications in the practice of transplantation with an incidence of 3 to 20 percent. This study was conducted to identify the risk factors for development of PTDM.
In a case-control study, 22 PTDM patients were compared with 44 transplanted controls matched for age, gender, immunosuppressive therapy and transplant year, all transplanted during 2003-2004 in our transplant research center. PTDM was defined by fasting glycemia of _140 mg/dL and the need for insulin therapy for more than 2 weeks. The clinical and laboratory data were collected before and monthly after transplant for 6 months. In the PTDM patients, the mean (±SD) age was 42.5 (±2.3) yr and the M/F ratio was 19/3. The mean (±SD) BMI was 22.9 (±0.7) kg/m2. There was personal history of hypertension in 8 patients, polycystic kidney disease in 5, and nephrotic syndrome in 2 cases. Seven patients had a family history of DM in 1st degree and 5 patients in 2nd degree relatives. All patients were on hemodialysis before transplantation. There was no significant difference between the case and control group for the history of hemodialysis but the PTDM patients had a significant higher weight (P=0.002) and BMI (P=0.055) and a higher frequency for personal history of hypertension and polycystic kidney disease (P <0.001), and family history of DM (p=0.04). There was no significant difference for mean cholesterol, triglycerides, LDL-C, and HDL-C before and after transplant in each group and between two groups. Eight patients in the case and 4 patients in the control group had transplant rejection (P=0.013). In this study, weight, BMI, personal history of hypertension and polycystic kidney disease, family history of diabetes, and kidney rejection were correlated with PTDM.