Oral Glucose Tolerance Test for the Screening of Glucose Intolerance Long Term Post-Heart Transplantation

• Published in: Transplant international Vol. 35; p. 10113
• Main Authors: Roest, Stefan, Goedendorp-Sluimer, Marleen M, Köbben, Julia J, Constantinescu, Alina A, Taverne, Yannick J H J, Zijlstra, Felix, Zandbergen, Adrienne A M, Manintveld, Olivier C
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 19-04-2022
• Subjects: Adult; Blood Glucose; Diabetes Mellitus - etiology; Female; Glucose Intolerance - diagnosis; Glucose Intolerance - epidemiology; Glucose Intolerance - etiology; Glucose Tolerance Test; Glycated Hemoglobin A - analysis; Health Archive; Heart Transplantation - adverse effects; Humans; Male; Middle Aged; Prediabetic State - diagnosis; Prediabetic State - epidemiology; Prediabetic State - etiology; comorbidity; oral glucose tolerance test; heart transplantation; post-transplant diabetes mellitus; prediabetes
• ISSN: 1432-2277; 0934-0874; 1432-2277
• DOI: 10.3389/ti.2022.10113

Post-transplant diabetes mellitus (PTDM) is a frequent complication post-heart transplantation (HT), however long-term prevalence studies are missing. The aim of this study was to determine the prevalence and determinants of PTDM as well as prediabetes long-term post-HT using oral glucose tolerance tests (OGTT). Also, the additional value of OGTT compared to fasting glucose and glycated hemoglobin (HbA1c) was investigated. All patients > 1 year post-HT seen at the outpatient clinic between August 2018 and April 2021 were screened with an OGTT. Patients with known diabetes, an active infection/rejection/malignancy or patients unwilling or unable to undergo OGTT were excluded. In total, 263 patients were screened, 108 were excluded. The included 155 patients had a median age of 54.3 [42.2-64.3] years, and 63 (41%) were female. Median time since HT was 8.5 [4.8-14.5] years. Overall, 51 (33%) had a normal range, 85 (55%) had a prediabetes range and 19 (12%) had a PTDM range test. OGTT identified prediabetes and PTDM in more patients (18% and 50%, respectively), than fasting glucose levels and HbA1c. Age at HT (OR 1.03 (1.00-1.06),
= 0.044) was a significant determinant of an abnormal OGTT. Prediabetes as well as PTDM are frequently seen long-term post-HT. OGTT is the preferred screening method.