New-onset diabetes mellitus after liver transplantation in the patients with acute liver failure

Abstract

Background

To detect the frequency and possible risk factors of new-onset diabetes after liver transplantation in the patients with acute liver failure. The frequency of new-onset diabetes after transplant (NODAT) is 5–30% in liver transplant recipients. We aimed to analyze the frequency and predictors of NODAT in the patients undergoing liver transplantation due to acute liver failure.

Methods

Adult patients undergoing liver transplantation due to acute liver failure were analyzed retrospectively. The patients with chronic liver failure or diabetes were excluded. We measured pretransplant random blood glucose and posttransplant fasting blood glucose. NODAT was diagnosed according to principally 1st month fasting blood glucose (group 1 < 100, group 2 100–125, group 3 > 125 mg/dL). The participants were subgrouped according to age, gender, body mass index, etiology, antiviral medication, thyroid function, pretransplant random blood glucose, donor type, immunosuppressive drug, common infection, and surgical complication.

Results

Mean age of total 91 patients was 33.48 (± 13.35), and 52.7% (n = 48) of them was female. The ratio of NODAT was 26.98% on the 1st month. NODAT group had a higher pretransplant random blood glucose than the others. Pretransplant hyperglycemia increased the risk of NODAT by 4.065 times (p = 0.018).

Conclusion

We showed that pretransplant hyperglycemia increased NODAT risk by 4 times, but hypoglycemia did not affect. So, pretransplant hyperglycemia should be controlled also in the patients with acute liver failure as in the patients with chronic liver failure.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

We had accepted that “the previous form” of our article could be located on a website of “https://www.researchsquare.com/article/rs-14864/v1” as a preprint, before we have submitted the article to your journal. We changed some parts of the article and title, before we have submitted our article to your journal. The authors assure that this paper has not been published before nor has been submitted for publication to another scientific journal.

The abstract of previous form of our article was accepted as an “Audio Electronic Poster” (AEP-306) with a heading of “New-Onset Diabetes Mellitus After Liver Transplantation In The Patients With Acute Liver Failure: Is There Any Effect Of Pretransplant Hypoglycemia?” in 2020 online congress of European Society of Endocrinology (e-ECE 2020).

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Acknowledgements

All authors contributed to the study conception and design. Study design, material preparation, data collection, and analysis were performed by Ömercan Topaloğlu, Muhammet Cengiz, Ayşe Cengiz, Bahri Evren, Saim Yoloğlu, Sezai Yılmaz, and İbrahim Şahin. The first draft of the manuscript was written by Ömercan Topaloğlu, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ömercan Topaloğlu.

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Ethics approval and consent to participate

Our study was designed as retrospective manner, and we performed our study in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Our study was approved by the Ethics Committee of Inonu University (Malatya Clinical Researches Ethic Committee, approval date:04 January 2017, approval number:2017/11).

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Due to the retrospective design of the study and the use of already available data, written informed consent was unavailable.

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Topaloğlu, Ö., Cengiz, M., Cengiz, A. et al. New-onset diabetes mellitus after liver transplantation in the patients with acute liver failure. Int J Diabetes Dev Ctries (2021). https://doi.org/10.1007/s13410-021-00922-y

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Keywords

  • NODAT
  • Acute liver failure
  • Liver transplant
  • Posttransplant diabetes
  • New onset diabetes
  • Diabetes mellitus