TY - JOUR
T1 - International consensus on post-transplantation diabetes mellitus
AU - Sharif, Adnan
AU - Chakkera, Harini
AU - de Vries, Aiko P.J.
AU - Eller, Kathrin
AU - Guthoff, Martina
AU - Haller, Maria C.
AU - Hornum, Mads
AU - Nordheim, Espen
AU - Kautzky-Willer, Alexandra
AU - Krebs, Michael
AU - Kukla, Aleksandra
AU - Kurnikowski, Amelie
AU - Schwaiger, Elisabeth
AU - Montero, Nuria
AU - Pascual, Julio
AU - Jenssen, Trond G.
AU - Porrini, Esteban
AU - Hecking, Manfred
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/3/1
Y1 - 2024/3/1
N2 - Post-transplantation diabetes mellitus (PTDM) remains a leading complication after solid organ transplantation. Previous international PTDM consensus meetings in 2003 and 2013 provided standardized frameworks to reduce heterogeneity in diagnosis, risk stratification and management. However, the last decade has seen significant advancements in our PTDM knowledge complemented by rapidly changing treatment algorithms for management of diabetes in the general population. In view of these developments, and to ensure reduced variation in clinical practice, a 3rd international PTDM Consensus Meeting was planned and held from 6–8 May 2022 in Vienna, Austria involving global delegates with PTDM expertise to update the previous reports. This update includes opinion statements concerning optimal diagnostic tools, recognition of prediabetes (impaired fasting glucose and/or impaired glucose tolerance), new mechanistic insights, immunosuppression modification, evidence-based strategies to prevent PTDM, treatment hierarchy for incorporating novel glucose-lowering agents and suggestions for the future direction of PTDM research to address unmet needs. Due to the paucity of good quality evidence, consensus meeting participants agreed that making GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) recommendations would be flawed. Although kidney-allograft centric, we suggest that these opinion statements can be appraised by the transplantation community for implementation across different solid organ transplant cohorts. Acknowledging the paucity of published literature, this report reflects consensus expert opinion. Attaining evidence is desirable to ensure establishment of optimized care for any solid organ transplant recipient at risk of, or who develops, PTDM as we strive to improve long-term outcomes.
AB - Post-transplantation diabetes mellitus (PTDM) remains a leading complication after solid organ transplantation. Previous international PTDM consensus meetings in 2003 and 2013 provided standardized frameworks to reduce heterogeneity in diagnosis, risk stratification and management. However, the last decade has seen significant advancements in our PTDM knowledge complemented by rapidly changing treatment algorithms for management of diabetes in the general population. In view of these developments, and to ensure reduced variation in clinical practice, a 3rd international PTDM Consensus Meeting was planned and held from 6–8 May 2022 in Vienna, Austria involving global delegates with PTDM expertise to update the previous reports. This update includes opinion statements concerning optimal diagnostic tools, recognition of prediabetes (impaired fasting glucose and/or impaired glucose tolerance), new mechanistic insights, immunosuppression modification, evidence-based strategies to prevent PTDM, treatment hierarchy for incorporating novel glucose-lowering agents and suggestions for the future direction of PTDM research to address unmet needs. Due to the paucity of good quality evidence, consensus meeting participants agreed that making GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) recommendations would be flawed. Although kidney-allograft centric, we suggest that these opinion statements can be appraised by the transplantation community for implementation across different solid organ transplant cohorts. Acknowledging the paucity of published literature, this report reflects consensus expert opinion. Attaining evidence is desirable to ensure establishment of optimized care for any solid organ transplant recipient at risk of, or who develops, PTDM as we strive to improve long-term outcomes.
KW - GLP-1 analogues
KW - metabolic syndrome
KW - NODAT
KW - post-transplant diabetes mellitus
KW - SGLT2 inhibitors
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U2 - 10.1093/ndt/gfad258
DO - 10.1093/ndt/gfad258
M3 - Article
C2 - 38171510
AN - SCOPUS:85186394673
SN - 0931-0509
VL - 39
SP - 531
EP - 549
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 3
ER -