1689-P: Perioperative Hyperglycemia around Renal Transplantation Surgery and the Development of New-Onset Diabetes Mellitus after Transplantation

Background: New onset of diabetes after transplantation (NODAT) is an important problem as it increases infectious and cardiovascular complications reducing patient and graft survival.

Aim: To establish the impact of perioperative hyperglycemia on the development of NODAT and the other known risk factors for its development in patients who go to renal transplant surgery, in a renal transplant unit dependent on an academic center.

Methods: Study of cases and controls of patients with renal transplantation who developed or not NODAT within the year of follow-up, with more than 18 years of age, with the same immunosuppressive scheme (prednisone, tacrolimus, mycophenolate mofetil).

Results: Of 71 transplanted patients, 14 (19.7%) developed NODAT per year, with an average age of 37.57 ± 15.02 years vs. 36.08 ± 12.43 years for those who did not develop it (p: 0, 73) respectively; those who developed NODAT were male in 57.14% vs. 70.18% of those who did not develop it respectively. Patients whose preoperative laboratory evaluation showed blood glucose equal to or greater than 100 mg/dl and less than 126 mg/dl had a NODAT frequency of 21.3% vs. 5.26% (OR 4.9 p: 0.005) in those who they had values ​​lower than 100 mg/dl at the same time of the evaluation. In addition, if the blood glucose prior to hospital discharge was ≥140 mg/dl, the frequency of NODAT was 35.71% vs. 1.75% (OR 31.11 p: 0.0003) if the blood glucose was lower than 140 mg/dl at the same time of the evaluation. None of the other risk factors considered: age >40 years, female sex, overweight, obesity, hypertriglyceridemia, family history of diabetes had significant statistical differences between the two groups.

Conclusion: In our experience, poor glycemic controls, especially before surgery and prior to hospital discharge, marked a higher frequency trend of NODAT one year after follow-up. The patients presenting with this phenomenon should be observed with special attention in the follow up.