Glucose tolerance in a cohort of Egyptian children after kidney transplantation

• Published in: Diabetes research and clinical practice 2021-02, Vol.172, p.108605-108605, Article 108605
• Main Authors: Arafa, Noha, Bazaraa, Hafez M., Sharaf ElDin, Heba, Hussein, Mofeeda, Salah, Doaa M.
• Format: Article
• Language: English
• Subjects: Adolescent; Blood Glucose - analysis; Child; Cohort Studies; Diabetes Mellitus - epidemiology; Diabetes Mellitus - etiology; Egypt - epidemiology; Female; Glucose Intolerance - epidemiology; Glucose Intolerance - etiology; Glucose metabolism; Glucose Tolerance Test; Humans; Insulin - blood; Insulin Resistance; Kidney transplantation; Kidney Transplantation - adverse effects; Male; Pediatric; Post- transplantation diabetes; Prediabetic State - epidemiology; Prediabetic State - etiology
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2020.108605

•This is the first report from our transplantation center focusing on detection of the magnitude of this problem.•The aim was to assess the glucose metabolic status among pediatric kidney transplant recipients.•We found that the frequency of abnormal glucose metabolism is high (23.3%); PTDM represented 10%.•Fasting plasma glucose as screening tool will under diagnose the problem. OGTT is standard method.•Obesity is a modifiable risk factors that need to be considered. Post- transplantation diabetes mellitus (PTDM) in children is a serious metabolic complication that can endanger both graft and patient survival. These complications can be partially reduced by early diagnosis & prompt treatment of impaired glucose tolerance. The aim of this study was to assess glucose tolerance & insulin resistance among a cohort of kidney transplanted children. Thirty consecutive pediatric kidney transplant recipients were subjected to basal evaluation of plasma glucose and insulin then underwent oral glucose tolerance test (OGTT). Abnormal glucose metabolism was detected in 7 (23.3%) patients; 3 (10%) patients with PTDM; 3 (10%) patients with impaired fasting glucose (IFG) and 1 (3.3%) patient with IFG and impaired glucose tolerance (IGT). Four (13.3%) patients had high Homeostatic model assessment of insulin resistance (HOMA-IR). Patients with abnormal glucose metabolism had significantly higher tacrolimus trough levels and higher maintainence steroid doses (p values = 0.003,0.026). Significant positive correlation existed between pre-transplantation glucose level and post-transplantation fasting glucose (p = 0.001, r = 0.69), glucose at 120 min (p = 0.018, r = 0.429) and HOMA-IR (p = 0.008, r = 0.47). Abnormalities in glucose metabolism (IFG, IGT &PTDM) are frequent in Egyptian pediatric kidney transplant recipients. OGTT is the gold standard for assessment of abnormalities in glucose metabolism.