Bechtold, Susanne M., Rohrer, Tilman R., Raile, Klemens, Hofer, Sabine, Thon, Angelika, Boettcher, Claudia, Konrad, Katja, Pozza, Robert Dalla, Bollow, Esther and Holl, Reinhard W. (2018). Diabetes mellitus in pediatric solid organ recipients without and with cystic fibrosis: An analysis from the German-Austrian diabetes database (Diabetes Patienten Verlaufsdokumentation). Pediatr. Diabetes, 19 (7). S. 1191 - 1198. HOBOKEN: WILEY. ISSN 1399-5448

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Abstract

Introduction: Posttransplantation diabetes mellitus (PTDM) increases the risk of cardiovascular disease, graft loss, and decreased survival. Follow-up treatment after solid organ transplantation (SOT) needs to focus on, inter alia, maintaining balanced glucose metabolism. This study aimed to ascertain the prevalence of PTDM and describe patient characteristics in the large DPV (Diabetes Patienten Verlaufsdokumentation) pediatric diabetes database. Methods: DPV data of 71902 patients from the January 01, 1995 to January 04, 2015 period were analyzed for patients with and without cystic fibrosis (CF) after SOT (kidney, liver, heart, and lung). Multivariable analysis served to assess differences between SOT patient groups at risk for developing diabetes. Results: Out of 109 SOT patients, 51 had CF; 72.5% received steroids and 62% were additionally given tacrolimus. PTDM developed in 45% of CF patients and 12% of non-CF patients. SOT patients were older at diabetes onset (mean age, 12.50 +/- 3.98 years), shorter (height z-score, -1.67 +/- 1.25), and lighter (weight z-score, -1.59 +/- 1.57) than non-SOT diabetes patients (P < 0.01). With transplantation, glycated hemoglobin (HbA1c) was significantly lower and treatment for hypertension and dyslipidemia was increased. Among SOT patients, weight and body mass index (BMI) z-scores were significantly lower in patients with CF-related diabetes (P < 0.05). Conclusions: SOT was present in 6.6% of children with diabetes, and this might aggravate the risk of cardiovascular disease in populations with already increased rates of hypertension and dyslipidemia. Dystrophy and short stature were also present, particularly in transplant recipients with CF and diabetes. Comorbidities and long-term consequences call for multidisciplinary collaboration.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bechtold, Susanne M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rohrer, Tilman R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Raile, KlemensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hofer, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thon, AngelikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boettcher, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Konrad, KatjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pozza, Robert DallaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bollow, EstherUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holl, Reinhard W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-168664
DOI: 10.1111/pedi.12725
Journal or Publication Title: Pediatr. Diabetes
Volume: 19
Number: 7
Page Range: S. 1191 - 1198
Date: 2018
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1399-5448
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
RENAL-TRANSPLANT RECIPIENTS; RISK-FACTORS; CHILDREN; GROWTH; MANAGEMENT; GRAFT; DPVMultiple languages
Endocrinology & Metabolism; PediatricsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/16866

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