Investigation of prediabetes and diabetes development frequency, risk factors and treatments in patients with liver transplant

8.ABSTRACT INTRODUCTION: One of the most important metabolic complications affecting mortality and morbidity after liver transplant is the new onset of diabetes or prediabetes. Immunosuppressive agents such as corticosteroids, tacrolimus, and sirolimus significantly increase the risk of post-transplant diabetes mellitus(PTDM), also known as new onset diabetes after transplant (NODAT). Assessing the risk factors regarding the onset of PLTDM, before and after liver transplant, and taking appropriate precautions considerably increase graft survival. MATERIAL AND METHOD: A retrospective study among the patients who had liver transplants in Akdeniz University Transplantation Department between September 1st, 2010 and December 31st, 2020 and who had not been diagnosed with diabetes prior to the transplant was undertaken by using the patient files and the hospital's database. A total of 221 patients were included. Demographic features(age, gender), pretransplant risk factors and posttransplant risk factors of included patients were evaluated. RESULTS: 28,1% of patients developed PTDM while 29,9% of patients developed prediabetes. 90.3% of the patients who developed PLTDM were diagnosed within the first year following transplantation. The presence of prediabetes (p<0.001) before transplantation and hypomagnesemia (p=0.01) detected within the first month after transplantation were found to be independent risk factors for the development of PTDM. Age at transplantation (p=0.043) and male gender (p=0.012) were found to be independent risk factors for the development of prediabetes. HbA1c was found to be <8% in the group developing diabetes after transplantation. The effects of the diabet treatment groups on HbA1c levels were found to be similar. CONCLUSIONS: Identifying the risk factors related to the development of prediabetes and diabetes in patients undergoing liver transplantation, making the diagnosis in the early period, and making appropriate treatment choices and changes are important in terms of reducing the risks of patient and graft loss, infections as well as cardiovascular complications.