New-onset diabetes mellitus after transplantation in patient undergoing a second kidney transplantation

Ivan Virnanda Amu, Maruhum Bonar Hasiholan Marbun, Endang Susalit

Research output: Contribution to journalShort surveypeer-review


New-onset diabetes mellitus after transplantation (NODAT) is the occurrence of diabetes mellitus in a previously nondiabetic person after solid organ transplantation. NODAT frequently occurs after organ transplantation and increasing risk of infection and mortality rates. The aim of this case report is to show that the treatment of NODAT by replacing tacrolimus with cyclosporin as well as using oral antidiabetic drug. We reported A 45-year-old man at Kidney Transplantation Center Cipto Mangunkusumo Hospital, Jakarta. He was diagnosed with hypertension since 2005 and chronic kidney disease since 2012, underwent the first kidney transplantation in 2014 and received tacrolimus 0.5 mg twice-daily, mycophenolic acid 180 mg twice-daily and methylprednisolone 16 mg once-daily. He experienced worsening kidney function in 2019, underwent hemodialysis since April 2020 and underwent a second kidney transplantation in December 2020. The initial treatment included tacrolimus XL 3 mg once-daily, diltiazem CD 200 mg once-daily, methylprednisolone 4 mg once-daily, mycophenolate mofetil 500 mg twice-daily. Laboratory examination May 2023 revealed, ureum 32.1 mg/dL, creatinine 0.80 mg/dL, estimated glomerular filtration rate (eGFR) 107.9 mL/min/1.73 m2, fasting blood glucose 180 mg/dL, 2-hour postprandial glucose 333 mg/dL, HbA1C 12.8%, urinalysis glucose 1+, tacrolimus 3.9 ng/dL. At that time the therapy was changed from tacrolimus XL 3 mg to cyclosporine 100 mg twice-daily, and metformin 500 mg twice-daily. Currently the patient has no complaints. Laboratory examination revealed ureum 55.6 mg/dL, creatinine 1.1 mg/dL, eGFR 80.6 mL/min/1.73 m2, fasting blood glucose 139 mg/dL, 2-hour postprandial glucose 162 mg/dL, cyclosporine plasma concentration 248.7 ng/dL. NODAT has been reported in a patient undergoing a second kidney transplantation. Replacing of tacrolimus with cyclosporine as well as oral antidiabetic drug was carried out as the management of NODAT in this patient.

Original languageEnglish
Pages (from-to)S40
JournalKorean Journal of Transplantation
Publication statusPublished - 2023


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