Post Transplant Diabetes Mellitus in Ahmed Gasim Kidney Transplant Center, Sudan

Abstract

Introduction: New onset post transplant diabetes mellitus (PTDM) is a common complication of kidney transplantation with a negative impact on patient and graft survival. Non-white ethnicity is a well known risk factor for PTDM. Methods: This is a retrospective study of 221 Sudanese patients who received live donor kidney transplantation in Ahmed Gasim kidney transplant center between December 2001 and December 2007, focusing on the incidence, clinical course and prognosis of PTDM
during the first post transplant year, and relating this to calcineurin inhibitor use. Results: The 12 months cumulative incidence of PTDM in our transplant population was 17.6% and all cases required treatment with insulin. 53.8% of PTDM cases were transient with a median duration of 76 days; by 12 months post transplant only 6.2% of patients were receiving insulin. The 12 months cumulative incidence of PTDM was higher in the tacrolimus compared to cyclosporine groups (25.4% versus 6.6%; OR 4.8, 95% CI: 1.9-12.1; P=0.00). During the follow up period 57.6% of PTDM patients in the tacrolimus group were able to discontinue insulin compared to 33.3% of PTDM patients in the cyclosporine groups (OR 2.7, 95% CI: 0.4-17; P=0.3). By 12 months post transplant, the proportion of patients receiving insulin was not significantly different between the two groups (8.0% versus 4.0%; OR 2.1, 95% CI 0.5-8.4; P = 0.2). Conclusion: The incidence of PTDM in our transplant
population is not different from that reported in published
randomized controlled trials and similarly, in the majority of cases PTDM was transient.

Key words: Post transplant diabetes mellitus, kidney transplantation, tacrolimus, cyclosporine, calcineurin inhibitor