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New-onset diabetes after transplantation: focus on treatment strategies

Anna Marino, Aysha Inankur & Lisa Tannock

New-onset diabetes after transplantation is an increasingly common complication after solid organ or bone marrow transplantation. New-onset diabetes after transplantation is a multifactorial condition involving both host and donor risk factors. Diabetes mellitus decreases graft and, thus, patient survival, with an excess mortality attributed primarly to cardiovascular disease. Like Type 2 diabetes mellitus, treatment involves a stepwise approach. Lifestyle modification plays a key role in therapy. Glycemic control may improve if glucocorticoids and calcineurin inhibitors can be replaced by medications with less diabetogenic potential. Beyond glycemic control, antihypertensives, lipid treatment and aspirin are key components of therapy. However, these agents must be carefully chosen to avoid interactions with antirejection medications.