Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/811
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dc.contributor.authorCohney, Solomon (Shlomo)-
dc.contributor.otherYates, Christopher-
dc.contributor.otherFourlanos, S.-
dc.contributor.otherColman, P. C.-
dc.date.accessioned2016-10-05T03:27:01Z-
dc.date.available2016-10-05T03:27:01Z-
dc.date.issued2013-11-
dc.identifier.citationTransplantation. 2013 Oct 27;96(8):726-31en_US
dc.identifier.issn1534-6080en_US
dc.identifier.issn0041-1337en_US
dc.identifier.urihttp://hdl.handle.net/11434/811-
dc.description.abstractBACKGROUND: The sensitivity of fasting plasma glucose (FPG) in screening for new-onset diabetes after transplantation (NODAT) has been questioned, particularly in the presence of moderate-dose prednisolone, where peak plasma glucose occurs 7 to 8 hr after administration. Oral glucose tolerance testing (OGTT) has been mooted as an alternative but is inconvenient for patients. METHODS: We compared sensitivity of screening tests for NODAT at 6 weeks, 3 months, and 12 months after kidney transplantation in recipients receiving prednisolone, mycophenolate, and tacrolimus. RESULTS: At 6 weeks, NODAT (capillary blood glucose [CapBG] ≥11.1 mmol/L, FPG ≥7.0 mmol/L, 2-hr plasma glucose ≥11.1 mmol/L, or glycated hemoglobin [HbA1c] ≥6.5%) was detected in 46% with CapBG versus 12% with OGTT (P=0.013), 4% with HbA1c (P<0.001), and 0% with FPG (P<0.001; n=26). At 3 months, NODAT was present in 14% with HbA1c versus 20% with OGTT (P=0.600) and 2% with FPG (P=0.059; n=50), whereas, at 12 months, NODAT was found in 4% with HbA1c versus 6% with OGTT (P=1.00) and 2% with FPG (P=0.618; n=51). Combining 3- and 12-month data, OGTT recorded NODAT in 14% and impaired glucose tolerance in 28%, whereas HbA1c detected NODAT in 10% and impaired glucose tolerance (from ≥5.7 to <6.5%) in 51%. Employing HbA1c as a screening test and reserving OGTT for those with impaired glucose tolerance would detect NODAT with a sensitivity more than 94%, avoiding the need for OGTT in 49% of patients. CONCLUSIONS: This study confirms the inadequacy of FPG screening for NODAT in the first 6 weeks after transplantation, at which time 4 p.m. CapBG also outperformed OGTT. From 3 months, HbA1c had similar sensitivity to OGTT and represents a convenient alternative.en_US
dc.publisherWolters Kluweren_US
dc.subjectBlood Glucoseen_US
dc.subjectCircadian Rhythmen_US
dc.subjectGlucocorticoidsen_US
dc.subjectGlucose Tolerance Testen_US
dc.subjectGraft Rejectionen_US
dc.subjectHemoglobin Aen_US
dc.subjectHyperglycemiaen_US
dc.subjectImmunosuppressive Agentsen_US
dc.subjectKidney Transplantationen_US
dc.subjectMycophenolic Aciden_US
dc.subjectGlycosylateden_US
dc.subjectPostoperative Complicationsen_US
dc.subjectPrednisoloneen_US
dc.subjectTacrolimusen_US
dc.subjectPrednisoloneen_US
dc.subjectFasting Plasma Glucoseen_US
dc.subjectFPGen_US
dc.subjectNew-Onset Diabetes After Transplantationen_US
dc.subjectNODATen_US
dc.subjectOGTTen_US
dc.subjectOral Glucose Tolerance Testingen_US
dc.subjectUroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australiaen_US
dc.subjectDepartment of Nephrology, Epworth HealthCare, Richmond, Victoria, Australia.en_US
dc.titleScreening for new-onset diabetes after kidney transplantation: limitations of fasting glucose and advantages of afternoon glucose and glycated hemoglobin.en_US
dc.typeJournal Articleen_US
dc.identifier.doi10.1097/TP.0b013e3182a012f3en_US
dc.identifier.journaltitleTransplantationen_US
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/23902993en_US
dc.description.affiliatesDepartment of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Renal Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia.en_US
dc.description.affiliatesDepartment of Medicine, NorthWest Academic Centre, University of Melbourne, St Albans, Victoria, Australiaen_US
dc.type.studyortrialComparative Studyen_US
dc.type.contenttypeTexten_US
Appears in Collections:UroRenal, Vascular

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