Journal List > J Korean Diabetes > v.15(3) > 1054920

Yun and Kang: Management of Diabetes in Organ Transplant Patients

Abstract

New onset diabetes after transplantation (NODAT) is a common complication after solid-organ transplantation and is associated with increased cardiovascular morbidity, mortality, and graft loss. The risk factors for NODAT include older age, ethnicity, genetic factors, obesity, family history of diabetes, hepatitis C virus infection, and immunosuppressant use (corticosteroids, calcineurin inhibitors, and mTOR inhibitor). Management of NODAT must be considered at the pre-transplantation stage in order to properly screen high-risk patients. Although NODAT management is similar to that of general type 2 diabetes, some specific considerations must be made in NODAT management, including the interactions between anti-diabetes medication and immunosuppressive agents.

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Table 1.
Dosing of dipeptidyl peptidase-4 inhibitors in patients with renal insufficiency.
  Creatinine clearance (Ccr)
  > 50 mL/min 30–50 mL/min < 30 mL/min
Sitagliptin 100 mg QD 50 mg QD 25 mg QD
Vildagliptin 50 mg BID 50 mg QD 50 mg QD
Saxagliptin 5 mg QD 2.5 mg QD 2.5 mg QD
Linagliptin 5 mg QD 5 mg QD 5 mg QD
Alogliptin 25 mg QD 12.5 mg QD 6.25 mg QD
Gemigliptin 50 mg QD 50 mg QD 50 mg QD
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