Influence of Lifestyle Modification in Renal Transplant Recipients With Postprandial Hyperglycemia

作者：Adnan Sharif, Richard H. Moore, Keshwar Baboolal · 发表于：Transplantation · 年份：2008 · DOI：10.1097/tp.0b013e3181605ebf · 被引用次数：144 · 研究领域：Renal Transplantation Outcomes and Treatments、Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes

INTRODUCTION: Lifestyle modification is recommended as first-line therapy to manage new-onset diabetes after transplantation (NODAT) and impaired glucose tolerance (IGT). No data currently demonstrate the efficacy of this approach specifically for transplant recipients. This study aimed to assess the benefit of intensive lifestyle modification in this high-risk group and to contrast this with the natural evolution of glucose metabolism after transplantation. METHODS: Baseline oral glucose tolerance test (OGTT) stratified 115 patients into two groups. Group 1 had glucose intolerance, IGT (n=28) and NODAT (n=8), and received intensive lifestyle modification (dietician referral, exercise program, weight loss advice). Group 2 had normal glucose tolerance (n=79) and received lifestyle modification leaflets. Both groups had follow-up OGTT after 6 months to assess change in glycemic status. RESULTS: Excluding all patients who received steroid weaning or withdrawal as part of their management, 111 patients were included in the analysis. Lifestyle modification in group 1 resulted in 15% improvement in 2-hr postprandial glucose versus 12% deterioration in group 2. In group 1, 44% (n=11) of IGT patients developed normal glucose tolerance, whereas only 4% (n=1) developed NODAT. Fifty-eight percent (n=4) of NODAT patients showed improvement (29% to IGT and 29% to normal). Glucose metabolism deteriorated in group 2 with 14% (n=10) developing IGT and 3% (n=2) developing NODAT. CONCLUSIONS: ...