Post-Transplantations-Diabetes mellitus

ZUSAMMENFASSUNG

Die Zahl der Transplantationen ist rückläufig. Umso wichtiger ist eine konsequente Nachsorge zur Erhaltung der Transplantatfunktion. Eine häufige Komplikation (10–40 %) ist der Post-Transplantations-Diabetes mellitus (PTDM). Besonders im ersten Jahr ist das Erkrankungsrisiko hoch. Alter, Übergewicht, männliches Geschlecht, eine präexistente Insulinresistenz sowie die immunsuppressive Therapie begünstigen das Auftreten. Der PTDM führt zu hoher kardiovaskulärer Mortalität. Der orale Glukosetoleranztest (oGTT) stellt den Goldstandard der Diagnostik dar. Zusätzlich werden Nüchtern- und Spontanglukose sowie HbA1c herangezogen. Ein postoperativ diagnostizierter PTDM sollte mit Insulin behandelt werden. Eine frühe Intervention verzögert die Entwicklung einer relevanten Glukosestoffwechselstörung häufig über viele Monate. Die therapeutischen Möglichkeiten sind vielfältig und beinhalten neben der Blutzuckereinstellung die Behandlung kardiovaskulärer Risikofaktoren (Hyperlipidämie, Hypertonie). Patientenschulungen sind sinnvoll.

Publication History

Article published online:
20 July 2023

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