New onset of diabetes after transplantation - An overview of epidemiology, mechanism of development and diagnosis

Transplant Immunology

Volumn 30, Issue 1, 2014, Pages 52-58

  Kesiraju, Sailaja ^a,c   Paritala, Purna ^b   Rao Ch, Uma Maheswara ^b   Sahariah, S ^a,b  

^a Department of Biochemistry and Immunology ^*  (India)

^b KRISHNA INSTITUTE OF MEDICAL SCIENCES   (India)

^c Bhagwan Mahavir Medical Research Center   (India)

Author keywords

cell function; Epidemiology; NODAT; OGTT; Renal transplantation

Indexed keywords

CALCINEURIN INHIBITOR; CORTICOSTEROID; CYCLOSPORIN; EVEROLIMUS; MAMMALIAN TARGET OF RAPAMYCIN INHIBITOR; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PREDNISOLONE; RAPAMYCIN; TACROLIMUS;

CARDIOVASCULAR DISEASE; CELL FUNCTION; DIABETES MELLITUS; DRUG EXPOSURE; DRUG MEGADOSE; EARLY DIAGNOSIS; EPIDEMIOLOGICAL DATA; GLYCEMIC CONTROL; GRAFT FAILURE; GRAFT RECIPIENT; HIGH RISK PATIENT; HUMAN; INCIDENCE; INFECTION RISK; KIDNEY GRAFT; KIDNEY TRANSPLANTATION; MORNING DOSAGE; MORTALITY; NEW ONSET OF DIABETES AFTER TRANSPLANTATION; NONHUMAN; PANCREAS ISLET BETA CELL; PATHOPHYSIOLOGY; PATIENT IDENTIFICATION; PHYSICAL INACTIVITY; POSTOPERATIVE COMPLICATION; PREOPERATIVE EVALUATION; PRIORITY JOURNAL; REVIEW; RISK FACTOR; RISK REDUCTION; ANIMAL; EXERCISE; GRAFT REJECTION; IMMUNOLOGY; POSTOPERATIVE COMPLICATIONS;

ADRENAL CORTEX HORMONES; ANIMALS; DIABETES MELLITUS; EARLY DIAGNOSIS; GRAFT REJECTION; HUMANS; KIDNEY TRANSPLANTATION; POSTOPERATIVE COMPLICATIONS; RESTRAINT, PHYSICAL; RISK FACTORS;

EID: 84891828997     PISSN: 09663274     EISSN: 18785492     Source Type: Journal    
DOI: 10.1016/j.trim.2013.10.006     Document Type: Review

References (99)

1. Hjelmesaeth J., Hartmann A., Leivestad T., Holdass H., Sagedal S., Oistad M., et al. The impact of early diagnosed new-onset post-transplantation diabetes mellitus on survival and major cardiac events. Kidney Int 2006, 69:588-595.
2. Pietrzak-Nowacka M., Safranow K., Dziewanowski K., Debska-Slizien A., Glyda M., Golembiewska E., et al. Impact of post-transplant diabetes mellitus on graft function in autosomal dominant polycystic kidney disease patients after kidney transplantation. Ann Acad Med Stetin 2008, 54:41-48.
3. Siraj E.S., Abacan C., Chinnappa P., Wojtowicz J., Braun W. Risk factors and outcomes associated with pos- transplant diabetes mellitus in kidney transplant recipients. Transplant Proc 2010, 42:1685-1689.
4. Von Kiparski A., Frei D., Uhlschmid G., Largiader F., Binswanger U. Post-transplant diabetes mellitus in renal allograft recipients: A matched-pair control study. Nephrol Dial Transplant 1990, 5:220-225.
5. Valderhaug T.G., Hjelmesaeth J., Jenssen T., Roislien J., Lievestad T., Hartmann A., et al. Early posttransplantationhyperglycemia in kidney transplant recipients is associatedwith overall long-term graft losses. Transplantation 2012, 94:714-720.
6. Matas A.J., Gillingham K.J., Humar A., Ibrahim H.N., Payne W.D., Gruessner R.W., et al. Posttransplant diabetesmellitus and acute rejection: impact on kidney transplant outcome. Transplantation 2008, 85:338-343.
7. Valderhaug T.G., Hjelmesaeth J., Hartmann A., Roislien J., Bergrem H.A., Leivestad T., et al. The association of early post-transplant glucose levels with long-term mortality. Diabetologia 2011, 54(6):1341-1349.
8. Kasiske B.L., Snyder J.J., Gilbertson D., Matas A.J. Diabetes mellitus after kidney transplantation in the United States. Am J Transplant 2003, 3:178-185.
9. Cosio F.G., Pesavento T.E., Kim S., Osei K., Henry M., Ferguson R.M. Patient survival after renal transplantation. Impact of post-transplant diabetes. Kidney Int 2002, 62:1440-1446.
10. Cole E.H., Johnston O., Rose C.L., Gill J.S. Impact of acute rejection andnew-onset diabetes on long-term transplant graft and patient survival. Clin J Am Soc Nephrol 2008, 3:814-821.
11. Davidson J., Wilkinson A., Dantal J., Dotta F., Haller H., Hernandez D., et al. International Expert Panel. Proceedings of an international expert panel meeting. Barcelona, Spain, 19 February 2003 Transplantation 2003, 75:SS3-SS24. [Suppl.].
12. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003, 26(Suppl. 1):S5-S20.
13. Genuth S., Alberti K.G., Bennett P., Buse J., Defronzo R., Kahn R., et al. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003, 26:3160-3167.
14. American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care 2010, 33(Suppl. 1):S62-S69.
15. Burroughs T.E., Swindle J., Takemoto S., Lentine K.L., Machnicki G., Irish W.D., et al. Diabetic complications associated with new-onset diabetes mellitus in renal transplant recipients. Transplantation 2007, 83:1027-1034.
16. Wyzgal J., Paczek L., Sanko-Resmer J. Insulin resistance in kidney allograft recipients treated with calcineurin inhibitors. Ann Transplant 2007, 12:26-29.
17. Hur K.Y., Kim M.S., Kim Y.S., Kang E.S., Nam J.H., Kim S.H., et al. Risk factors associated with the onset and progress of post transplantation diabetes in renal allograft recipients. Diabetes care 2007, 30:609-615.
18. Woodward R.S., Schnitzler M.A., Baty J. Lowell, J.A, Lopez-Rocafort, L, Haider.S. et al. Incidence and cost of new onset diabetes mellitus among U.S. wait-listed and transplanted renal allograft recipients. Am J Transplant 2003, 3:590-598.
19. Madhav D., Ram R., Dakshinamurty K.V. Posttransplant Diabetes Mellitus: Analysis of Risk Factors, Effects on Biochemical Parameters and Graft Function 5 Years after renal transplantation. Transplant Proc 2010 Dec, 42(10):4069-4071.
20. Mathew J.T., Rao M., Job V., Ratnaswamy S., Jacob C.K. Post-transplant hyperglycaemia: A study of risk factors. Nephrol Dial Transplant 2003 Jan, 18(1):164-171.
21. Prakash J., Rathore S.S., Brojen Singh T., Alam Choudhury Tauhidul, Prabhakar Usah New onset of diabetes after transplantation (NODAT): Analysis of pre-transplant risk factors in renal allograft recipients. Indian J Transplant 2012, 6(3):77-82. [July-Sep 77-82.].
22. Saxena S., Dash S.C., Guleria S., Mittal R., Agarwal S.K., Tiwary S.C., et al. Post transplant diabetes mellitus in live related renal allograft recipients: a single centre experience. J Assoc Physicians India 1996 July, 44(7):477-479. [1-Jul-, 472].
23. Saboo D., Shah P.R., Goplani K.R., Feroz A., Gumber M., Vaniker A.V., et al. Post transplant Diabetes mellitus: A single center study. Transplant Proc 2008, 40:1111-1113.
24. Sharma R.K., Prakash R., Jeloka T., Gupta A., Gulati S., Sharma A.P., et al. Posttransplantdiabetes mellitus in renal transplant recipients-a single-center experience. Transplant Proc 2003 Feb, 35(1):266-267.
25. National Institutes of Health NIoDaDaKD. US Renal Data SystemUSRDS 2011 Annual Data Report: Atlas of Chronic KidneyDisease and End-Stage Renal Disease in the United States.
26. Johny K.V., Nampoory M.R., Costandi J.N., Gupta R.K., Ninan V.T., Samhan M., et al. High incidence of post transplant diabetes mellitus in Kuwait. Diabetes Res Clin Pract 2002, 55:123-130.
27. Nwankwo E.A., Bakari A.A., Ac Ene Post transplantation diabetes mellitus in kidney allograft recipients: Current concepts. SJKDT 2008, 19(6):904-910. [(Cross ref)].
28. Gourishankar S., Jhangri G.S., Tonelli M., Wales L.H., Cockfield S.M. Development of diabetes mellitus following kidney transplantation: A Canadian experience. AMJ Transplant 2004, 4:1876-1882.
29. Sarno G., Muscogiuri G., De Rosa P. New-onset diabetes after kidney transplantation: prevalence, risk factors, and management. Transplantation 2012, [Apr 3. PMID:22475764.].
30. Yagnik C.S. Diabetes and insulin resistance syndrome in Indians. Bull Nutr Found India 1995, 16:1-5.
31. Ramachandran A., Snehalatha C., Latha E., Viswanathan V., Viswanathan M. Rising prevalence of NIDDM in an urban population in India. Diabetologia 1997, 40:232-237.
32. Chakkera Harini, Knowler William C., Yugandhara D., Jennifer W., Heilman Raymond L., Amylou D., et al. Relationship between inpatient hyperglycemia and insulin treatment after kidney transplant and future new onset diabetes mellitus. Clin J Am Soc Nephrol 2010, 5:1669-1675.
33. Fridlyand L.E., Philipson L.H. Does the glucose dependent insulin secretion mechanism itself cause oxidative stress in pancreatic β-cell?. Diabetes 2004, 53:1942-1948.
34. Kaiser N., Leibowitz G., Nesher R. Gluco toxicity and β-cell failure in type 2 diabetes mellitus. J Paediatr Endocrinol Metab 2003, 16:5-22.
35. Mutel E., Gautier-Stein A., Abdul-Wahed A., Correig M.A., Zitoun C., Stefanutti A., et al. Control of blood glucose in the absence of hepatic glucose production during prolonged fasting in mice3:induction of renal and intestinal gluconeogenesis by glucagon. Diabetes 2011, 60(12):3121-3131.
36. Heit J.J., Apelqvist A.A., Gu X., Winslow M.M., Neilson J.R., Crabtree G.R., et al. Calcinurin/NFAT signaling regulates pancreatic beta-cell growth and function. Nature 2006, 443:345-349.
37. Hagen M., Hjelmesaeth J., Jenssen T., Morkrid L., Hartmann A. A 6-year prospective study on new onset diabetes mellitus, insulin release and insulin sensitivity in renal transplant recipients. Nephrol Dial Transplant 2003, 18:2154-2159.
38. Nam J.H., Mun J.I., Kim S.I., Kang S.W., Choi K.H., Park K., et al. Beta-Cell dysfunction rather than insulin resistance is the main contributing factor for the development of post renal transplantation diabetes mellitus. Transplantation 2001, 71:1417-1423.
39. Hecking Manfred, Werzowa Johannes, Haidinger Michael, Hörl Walter H. Pascual J, Budde K, et al. Novel views on new-onset diabetes after transplantation:development, prevention and treatment Full review. Nephrol Dial Transplant 2013, 1-15.
40. Hecking M., Haidinger M., Doller D., Werzowa J., Tura A., Zhang J., et al. Early basal insulin therapy decreases new-onset diabetes after renal transplantation. J Am Soc Nephrol 2012, 23:739-749.
41. Hohenstein B., Hausknecht B., Boehmer K., Reiss R., Brekken R.A., Hugo C.P.M. Local VEGF activity but not VEGF expression is tightly regulated during diabetic nephropathy in man. Kidney Int 2006, 69:1654-1661.
42. Osterby R., Asplund J., Bangstad H.J. NybergG, Rudberg G, Viberti GC, et al. Neovascularization at the vascular pole region in diabetic glomerulopathy. Nephrol Dial Transplant 1999, 14:348-352.
43. White K.E., Bilous R.W., Marshall S.M., Nahas M.E.I., Remuzzi G., Piras G., et al. Podocyte number in normotensive type 1 diabetic patients with albuminuria. Diabetes 2002, 51:3083-3089.
44. Dalla Vestra M., Masiero A., Roiter A.M., Saller A., Crepaldi G., Fioretto P. Is podocyte injury relevant in diabetic nephropathy? Studies in patients with type 2 diabetes. Diabetes 2003, 52:1031-1035.
45. Hoshi S., Nomoto K., Kuromitsu J., Tomari S, Nagata M. High glucose induced VEGF expression via PKC and ERK in glomerular podocytes. Biochem Biophys Res Commun 2002, 290:177-184. [177-184.].
46. Kang Y.S., Park Y.G., Kim B.K., Han S.Y., Jee Y.H., Han K.H., et al. Angiotensin II stimulates the synthesis of vascular endothelial growth factor through the p38 mitogen activated protein kinase pathway in cultured mouse podocytes. J Mol Endocrinol 2006, 36:377-388.
47. Torres-Romero L.F., Santiago-Delpin E.A., De Echegaray S. HLA is not predictive of post transplant diabetes mellitus. Transplant Proc 2006, 38:914-915.
48. Addous A., Mohammed A.S., Ismail G., Hashemy A.A. Post transplant diabetes mellitus in kidney transplant recipients with special reference to association with HLA antigens. Saudi J kidney Dis Tranpl 2000, 11:559-562.
49. Voight B.F., Scott L.J., Steinthorsdottir V., Morris A.P., Dina C., Welch R.P., et al. Twelve type 2 diabetes susceptibility loci identified through large-scale association analysis. Nat Genet 2010, 42:579-589.
50. Liu Z., Habener J.F. Wnt signaling in pancreatic islets. Adv Exp Med Biol 2010, 654:391-419.
51. Talmud P.J., Hingorani A.D., Cooper J.A., Marmot M.G., Brunner E.J., Kumari M., et al. Utility of genetic and non-genetic risk factor in prediction of type 2 diabetes: Whitehall II prospective cohort study. BMJ 2010, 340:b4838.
52. Porrini E., Delgado P., Bigo C., Alvarez A., Cobo M., Checa M.D., et al. Impact of metabolic syndrome on graft function and survival after cadaveric renal transplantation. Am J Kidney Dis 2006, 48:134-142.
53. Yates C.J., Fourlanos S., Hjelmesaeth J., Colman P.G., Cohney S.J. New-onset diabetes after Kidney transplantation- changes and challenges. Am J Transplant 2012, 12:820-828.
54. Pham P.T., Pham P.M., Pham S.V., Pham P.A., Pham P.C. New onset diabetes after transplantation (NODAT): an overview. Diabetes Metab Syndr Obes 2011, 4:175-186.
55. Hjelmesaeth J., Hartmann A., Kofstad J., Stenstrom J., Leivstad T., Egeland T., et al. Glucose intolerance after renal transplantation depends upon prednisolone dose and recipient age. Transplantation 1997, 64:979-983.
56. Chakkera H.A., Hanson R.L., Raza S.M., DiStefano J.K., Millis M.P., Heilman R.L., et al. Pilot study: Association of traditional and genetic risk factors and new-onset diabetes mellitus following kidney transplantation. Transplant Proc 2009, 41:4172-4177.
57. Shah T., Kasravi A., Huang E., Hayashi R., Young B., Cho Y.W., et al. Risk factors for development of new-onset diabetes mellitus after kidney transplantation. Transplantation 2006, 82:1673-1676.
58. Finni P.E., Souza E.R., Rioja S., Ventura S., Starling P., Almeida J.R., et al. Is hepatitis C a risk factor for post transplant diabetes mellitus after renal transplantation in patients using tacrolimus. Transplant proc 2004, 36:884-885.
59. Leung Ki En-Ling, Venetz Jean-Pierre, Meylan Pascal, Lamoth Fréderic, Ruiz Juan, Pascual Manuel Cytomegalovirus infection and new onset post transplant diabete mellitus. Clin transplant 2008, 22:245-249.
60. Hjelmesaeth J., Sagedal S., Hartmann A., Rollag H., Egeland T., Hagen M., et al. Asymptomatic cytomegalovirus infection is associated with increased risk of new-onset diabetes mellitus and impaired insulin release after renal transplantation. Diabetologia 2004, 47:1550-1556.
61. Numakura K., Satoh S., Tsuchiya N., Horikawa Y., Inoue T., Kakinuma H., et al. Clinical and genetic risk factors for post transplant diabetes mellitus in adult renal transplant recipients treated with tacrolimus. Tranplantation 2005, 80:1419-1424.
62. Sulanc E., Lane J.T., Puumala S.E., Groggel G.C., Wrenshall L.E. Stevens RB; New onset of diabetes after transplantation: an application of 2003 International Guidelines. Transplantation 2005, 80:945-952.
63. Lutsey P.L., Pankow J.S., Betoni A.G., Szklo M. Folsom AR; Serological evidence of infections and type 2 diabetes: the MultiEthnic study of Atherosclerosis. Diabet Med 2009, 26:149-152.
64. Hjelmesaeth J., Muller F., Jenssen T., Rollag H., Sagedal S., Hartmann A. Is there a link between cytomegalo virus infection and new-onset posttransplantation diabetes mellitus? Potential mechanisms of virus induced beta-cell damage. Nephrol Dial Transplant 2005, 20:2311-2315.
65. Sharif A., Baboolal K. Complications associated with new-onset diabetes after kidney transplantation. Nat Rev Nephrol 2012, 8:34-42.
66. De Mattos A.M., Olyaei A.J., Prather J.C., Golconda M.S., Barry J.M., Norman D.J. Autosomal-dominant polycystic kidney disease as a risk factor for diabetes mellitus following renal transplantation. Kidney Int 2005, 67:714-720.
67. Ducloux D., Motte G., Vautrin P., Vautrin C.B., Rebibou J.M., Chalopin J.M. Polycystic kidney disease as a risk factor for post-transplant diabetes mellitus. Nephrol Dial Transplant 1999, 14:1244-1246.
68. Hamer R.A., Chow C.L., Ong A.C., McKane W.S. Polycystic kidney disease is a risk factor for new- onset diabetes after transplantation. Transplantation 2007, 83:36-40.
69. Huscher D., Thiele K., Gromnica-Ihle E., Hein G., Demary W., Dreher R. Dose-related patterns of glucocorticoid- induced side effects. Ann Rheum Dis 2009, 68:1119-1124.
70. Qi D., Rodrigues B. Glucocorticoids produce whole body insulin resistance with changes in cardiac metabolism. Am J Physiol Endocrinol Metab 2007, 92:E654-E667.
71. Ullrich S., Berchtold S., Ranta F., Seebohm G., Henke G., Lupescu A., et al. Serum- and glucocorticoid inducible kinase- 1 (SGK1) mediates glucocorticoid-induced inhibition of insulin secretion. Diabetes 2005, 54:1090-1099.
72. Khan A., Ostenson C.G., Berggren P.O., Efendic S. Glucocorticoid increases glucose cycling and inhibits insulin release in pancreatic islets of ob/ob mice. Am J Physiol 1992, 263(4 Pt 1):E663-E666.
73. Koizumi M., Yada T. Sub-chronic stimulation of glucocorticoid receptor impairs and mineralocorticoid receptor protects cytosolic Ca2+ responses to glucose in pancreatic beta-cells. J Endocrinol 2008, 197:221-229.
74. Delaunay F., Khan A., Cintra A., Davani B., Ling Z.C., Andersson A., et al. Pancreatic beta cells are important targets for the diabetogenic effects of glucocorticoids. J Clin Invest 1997, 100:2094-2098.
75. Nagaraja P., Ravindran V., Morris-Stiff G., Baboolal K. Role of insulin resistance indices in predicting new-onset diabetes after kidney transplantation. Transpl Int 2013, Mar, 26(3):273-280.
76. Pascual J., Zamora J., Galeano C., Royuela A., Quereda C. Steroid avoidance or withdrawal for kidney transplant recipients. Cochrane Database Syst Rev 2009.
77. Luan F.L., Steffick D.E., Ojo A.O. New-onset diabetes mellitus in kidney transplant recipients discharged on steroid-free immunosuppression. Transplantation 2011, 91(3):334-341.
78. Cole E.H., Johnston O., Rose C.L., Gill J.S. Impact of acute rejection and new-onset diabetes on long-term transplant graft and patient survival. Clin J Am Soc Nephrol 2008, 3(3):814.
79. Ghisdal L., Baron C., Le Meur Y., Lionet A., Halimi J.M., Rerolle J.P. TCF7L2 polymorphism associates with new-onset diabetes after transplantation. J Am Soc Nephrol 2009, 20(11):2459-2467.
80. Montori V.M., Basu A., Erwin P.J., Velosa J.A., Gabriel S.E., Kudva Y.C. Posttransplantation diabetes: a systematic review of the literature. Diabetes Care 2002, 25(3):583-592.
81. Redmon J.B., Olson L.K., Armstrong M.B., MJ Green, RP Robertson Effects of tacrolimus (FK506) on human insulin gene expression, insulin mRNA levels, and insulin secretion in HIT-T15 cells. J Clin Invest 1996, 98(12):2786-2793.
82. Herold K.C., Nagamatsu S., Buse J.B., Kulsakdinun P., DF Steiner Inhibition of glucosestimulated insulin release from beta TC3 cells and rodent islets by an analog of FK506. Transplantation 1993, 55:186-192.
83. Van Hooff J.P., Christiaans M.H., van Duijnhoven E.M. Evaluating mechanisms of postransplant diabetes mellitus. Nephrol Dial Transplant 2004, 19:vi8-vi12.
84. Duijnhoven E.M., Boots J.M., Christiaans M.H., Wolffenbuttel B.H., VanHooff J.P. Influence of tacrolimus on glucose metabolism before and after renal transplantation: a prospective study. J Am Soc Nephrol 2001, 12:583-588.
85. Menegazzo L.A., Ursich M.J., Fukui R.T., Rocha D.M., Silva M.E., Ianhex L.E., et al. Mechanism of the diabetogenic action of cyclosporin A. Horm Metab Res 1998, 30(11):663-667.
86. Tamura K., Fujimura T., Tsutsumi T., Nakamura K., Ogava T., Atumaru C., et al. Transcriptional inhibition of insulin by FK506 and possible involvement of FK506 binding protein-12 in pancreatic beta-cell. Transplantation 1995, 59(11):1606-1613.
87. Heisil O., Heisel R., Balshaw R., Balshaw R., Keown P. New onset diabetes mellitus in patients receiving calcinuerin inhibitors: a systematic review and meta-analysis. Am J Transplant 2004, 4:583-595.
88. Webster A.C., Woodroffe R.C., Taylor R.S., Chapman J.R., Craig J.C. Tacrolimus versus ciclosporin as primary immunosuppression for kidney transplant recipients: meta-analysis of randomized trial data. BMJ 2005, 331-810.
89. Vincenti F., Friman S., Scheuermann E., Rostaing L., Jenssen T., Campistol J.M., et al. DIRECT (Diabetes Incidence after renal transplantation: Neoral C Monitoring versus Tacrolimus) Results of an international, randomized trial comparing glucose metabolism disorders and outcome with cyclosporine versus tacrolimus. Am J Tranplant 2007, 7(6):1506-1514.
90. Van Duijnhoven E.M., Christiaans M.H.L., Boots J.M.M., Nieman F.H.M., Wolffenbuttel B.H.R., Van Hooff J.P. Glucose metabolism in the first 3 years after renal transplantation in patients receiving tacrolimus versus cyclosporine-based immunosuppression. J Am Soc Nephrol 2002, 13(1):213-220.
91. Veroux M., Tiziano T., Daniela C., Singara N., Giaquinta A., Zerbo D., et al. Conversion to sirolimus therapy in kidney transplant recipients with new onset of diabetes mellitus after transplantation. Clin Dev Immunol 2013, 2013:496974.
92. Flechner S.M., Glyda M., Cockfield S., Grinyo J., Legendre Ch., Russ G., et al. The ORION study: Comparison of two sirolimus-based regimens versus tacrolimus and mycophenolate mofetil in renal allograft recipients. Am J Transplant 2011, 11:1633-1644.
93. Shivaswamy V., McClure M., Passer J., Frahm C., Ochsner L., Erikson J., et al. Hyperglycemia induced by tacrolimus and sirolimus is reversible in normal sprague-dawley rats. Endocrine 2010, 37(3):489-496.
94. Pereira M.J., Palming J., Rizell M., Aureliano M., Carvalho E., Svensson M.K., et al. mTOR inhibition with rapamycin causes impaired insulin signalling and glucose uptake in human subcutaneous and omental adipocytes. Mol Cell Endocrinol 2012, 355(1):96-105.
95. Hjelmesaeth J., Asberg A., Muller F., Hartmann A., Jenssen T. New-onset post Transplantation diabetes mellitus: insulin resistance or insulinopenia? Impact of immunosuppressive drugs, cytomegalovirus and hepatitis C virus infection. Curr Diabetes Rev 2005 Feb, 1(1):1-10.
96. Van Laecke S., Van Biesen W., Verbeke F., De Bacquer D., Peeters P., Vanholder R. Posttransplantation hypomagnesemia and its relation with immunosuppression as predictors of new-onset diabetes after transplantation. Am J Transplant 2009, 9:2140-2149.
97. Sharif A., Moore R., Baboolal K. Influence of lifestyle modification in renal transplant recipients with postprandial hyperglycemia. Transplantation 2008, 85(3):353-358. [Feb 15].
98. Valderhaug T.G., Hjelmesaeth J., Rollag H., Leivstad T., Roislien J., Jenssen T., et al. Reduced incidence of new-onset posttransplantation diabetes mellitus during the last decade. Transplantation 2007 Nov 15, 84(9):1125-1130.
99. Demirci M.S., Toz H., Yilmaz F., Ertilav M., Asci G., Ozkahya M., et al. Risk factors and consequences of post transplant diabetes mellitus. Clin Transplant 2010 Sep, 24(5):E170-E177.