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NODAT (New Onset Diabetes after Transplantation)

NODAT

nephroplus | April 19, 2017

By Mrinal Pandit, Chief Dietician, NephroPlus

NODAT is a diabetes defined by the WHO and ADA that develops for the first time after transplantation.

Although renal transplantation reverses the risk of cardiovascular disease by restoring back the kidney functions, it introduces new cardio vascular risk including impaired blood glucose level, dyslipidaemia and hypertension because of immune suppressive and anti-rejection medication given post-transplant.
The prevalence of NODAT after kidney transplantation ranges between 4 % – 25 % and it may occur until 6 month of transplant. The chances of graft rejection, infection, cardiovascular events and reduced survival rate are variably higher with NODAT compared with those who do not develop diabetes.

Risk factors of NODAT

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Preparing yourself for Transplant

  • Maintain your Ideal body weight- BMI above 30 kg/m2 is one of the strongest factor contributing to NODAT. Obesity is associated with insulin resistance and can be a strong marker for type 2 DM post-transplant.
  •  Keep your lipid in check-. Elevated triglyceride and glucose levels before transplantation increase the risk for NODAT. Both pre transplantation diabetes and new-onset diabetes after transplantation (NODAT) contribute to the risk for CVD and infection, reducing graft and patient survival.
  •  Be Active- Healthy lifestyle and physical activity is recommended to improve overall morbidity and cardiovascular outcomes. Guidelines suggest that patients with chronic kidney disease should have moderate-intensity physical activity of at least 30 minutes five times per week.
  •  Albumin Levels to be corrected- Pre-operative hypoalbuminemia is an independent risk factor for postoperative short- and long-term complications including higher risk of delayed graft function, cardiovascular death and higher risk of graft failure. Get your albumin checked regularly and include high protein foods in your daily meals.
  •  Treat Infections- HCV infection is a potentially modifiable risk factor for NODAT after kidney transplantation. Successful pre transplantation treatment of HCV potentially could reduce the incidence of NODAT. Discuss with your consultant about the available treatment.

If you planning to undergo transplant, prepare your immune system ahead of time and replenish your body’s nutrient store. A healthy body can handle the stress of the procedure efficiently and recovery can be smooth and faster.

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