实体器官移植后新发糖尿病是一种常见的并发症，且在某些肥胖症流行的国家则更为多见。目前已经明确不管是新发糖尿病还是糖尿病前期（空腹血糖和糖耐量异常）都能够影响移植后移植物和患者的生存率。推荐移植前后对糖耐量进行仔细的监测。虽然很多包括年龄、体重、种族、家族史以及丙型肝炎的感染与移植后新发糖尿病的关系密切，而肾上腺皮质激素的使用、钙调神经磷酸酶抑制剂甚至西罗莫司的使用在其病因学中起重要作用。移植后新发糖尿病的治疗通常和普通人群治疗2型糖尿病的指导原则保持一致。但是，我们需要更深入的研究明确该疾病最合适的免疫抑制方案。

New-onset diabetes mellitus after solid organ transplantation.

Bodziak KA, Hricik DE.

Department of Medicine, Division of Nephrology and Hypertension, Case Western Reserve University and the Transplantation Service, University Hospitals Case Medical Center, Cleveland, OH, USA.

New-onset diabetes mellitus is a common complication of solid organ transplantation and is likely to become even more common with the current epidemic of obesity in some countries. It has become clear that both new-onset diabetes and prediabetic states (impaired fasting glucose and impaired glucose tolerance) negatively influence graft and patient survival after transplantation. This observation forms the basis for recommending meticulous screening for glucose intolerance before and after transplantation. Although a number of clinical factors including age, weight, ethnicity, family history, and infection with hepatitis C are closely associated with the new-onset diabetes mellitus, immunosuppression with corticosteroids, calcineurin inhibitors and possibly sirolimus plays a dominant role in its pathogenesis. Management of new-onset diabetes after transplantation generally conforms to the guidelines for treatment of type 2 diabetes mellitus in the general population. However, further studies are needed to determine the optimal immunosuppressive regimens for patients with this disorder.