Transplantation

Lung Transplantation May Raise Diabetes, CV Risks

Patients who undergo lung transplantation have an increased risk for diabetes and cardiovascular disease (CVD) in the year following their procedure, according to new study findings presented at the American Diabetes Association’s 78th Scientific Sessions.

For their study, Joseph M Leung, MD, of the University of British Columbia in Vancouver, Canada, and colleagues assessed the prevalence of diabetes and CV risk factors among 172 lung transplant patients. Data were collected and assessed pre-transplantation and in the 12 months following transplantation from 2010 to 2016 via chart review and an electronic database.
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Results revealed that the prevalence of diabetes had increased from 21.5% pre-transplant to 41.4% at 12 months post-transplant, and the prevalence of dyslipidemia had increased from 20.9% to 30.3%. The researchers also observed increases in the following factors:

  • Diastolic blood pressure (71.2 mm Hg vs 76.5 mm Hg)
  • Weight (157.6 lbs vs 178.7 lbs)
  • Body mass index (24.5 kg/ m2 vs 27.0 kg/m2)

In addition, more patients used long-acting insulin (6.43% vs 12.90) and β-blockers (8.77% vs 18.71%) at 12 months post-transplant, and fewer patients used angiotensin converting enzyme inhibitors and angiotensin-receptor blockers post-transplant (23.39% vs 11.61%).

However, no differences between pre-transplant and 12 months post-transplant were observed for the following factors:

  • Hemoglobin A1C (6.4% vs 6.1%)
  • Fasting plasma glucose (5.96 mmol/L vs 5.49 mmol/L)
  • Proportions of patients receiving the following treatments:
    • Metformin (5.85% vs 2.58%)
    • Sulfonylurea (3.51% vs 0.65%)
    • Short-acting insulin (5.85% vs. 9.03%)
    • Statins (18.71% vs 13.55%)
    • Any type of anti-hyperglycemic (13.45% vs 16.77%)
    • Any type of anti-hypertensive (36.84% vs 30.97%)

“The prevalence of diabetes and CV risk factors observed 12-months after lung transplant was increased compared to pre-transplant,” the researchers wrote. “The reasons for this are unclear, but may be related to immunosuppressive medication.”

“Further study is needed to determine whether these risk factors contribute to an increased risk of adverse clinical outcomes and whether more systematic surveillance and management of these risk factors might mitigate this risk,” they concluded.

—Christina Vogt

Reference:

Leung JM, Almethel M, Partovi N, Yee J, Levy R, Paty B. Increased prevalence of diabetes mellitus after lung transplantation. Diabetes. 2018;67(Supplement 1). https://doi.org/10.2337/db18-229-LB