Current practices in prevention, screening, and treatment of diabetes in kidney transplant recipients: European survey highlights from the ERA DESCARTES Working Group

Laghrib, Yassine; Hilbrands, Luuk; Oniscu, Gabriel C.; Crespo Barrio, Marta; Gandolfini, Ilaria; Mariat, Christophe; Mjøen, Geir; Sever, Mehmet Sükrü; Watschinger, Bruno; Velioglu, Arzu; Demir, Erol; Gavela Martinez, Eva; De Weerd, Annelies; Dedinska, Ivana; Pippias, Maria; Massart, Annick; Abramowicz, Daniel; de Fijter, Johan Willem; De Block, Christophe; Hellemans, Rachel

Current practices in prevention, screening, and treatment of diabetes in kidney transplant recipients: European survey highlights from the ERA DESCARTES Working Group

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dc.contributor.author Laghrib, Yassine
dc.contributor.author Hilbrands, Luuk
dc.contributor.author Oniscu, Gabriel C.
dc.contributor.author Crespo Barrio, Marta
dc.contributor.author Gandolfini, Ilaria
dc.contributor.author Mariat, Christophe
dc.contributor.author Mjøen, Geir
dc.contributor.author Sever, Mehmet Sükrü
dc.contributor.author Watschinger, Bruno
dc.contributor.author Velioglu, Arzu
dc.contributor.author Demir, Erol
dc.contributor.author Gavela Martinez, Eva
dc.contributor.author De Weerd, Annelies
dc.contributor.author Dedinska, Ivana
dc.contributor.author Pippias, Maria
dc.contributor.author Massart, Annick
dc.contributor.author Abramowicz, Daniel
dc.contributor.author de Fijter, Johan Willem
dc.contributor.author De Block, Christophe
dc.contributor.author Hellemans, Rachel
dc.date.accessioned 2025-10-27T17:25:54Z
dc.date.available 2025-10-27T17:25:54Z
dc.date.issued 2024
dc.date.updated 2025-10-27T17:25:54Z
dc.description.abstract Background: Although post-transplant diabetes mellitus (PTDM) is a common complication after kidney transplantation, there are few data on prevention, optimal screening, and treatment strategies. Methods: The European Renal Association's DESCARTES working group distributed a web-based survey to European transplant centres to gather information on risk assessment, screening procedures, and management practices for preventing and treating PTDM in kidney transplant recipients. Results: Answers were obtained from 121/241 transplant centres (50%) across 15 European countries. Screening practices for diabetes mellitus during the transplant work-up varied, with only 13% of centres using the recommended oral glucose tolerance test (OGTT) and 14% not screening at all. At transplantation, 19% of centres tailored the immunosuppressive regimen based on perceived PTDM risk, using strategies such as cyclosporin use or early steroid withdrawal. Fifty-two percent adopted strict glycaemic control with basal insulin in the first days post-transplant. Sixty-eight percent had defined screening protocols for early PTDM (45 days-6 months), primarily based on fasting glycaemia and/or HbA1c, while only a minority (7%) incorporated an OGTT. Changes in immunosuppression were considered by 41% in cases of early hyperglycaemia (<45 days) and by 58% in established PTDM (>45 days). Besides insulin therapy, dipeptidyl peptidase-4 (DPP4) inhibitors and metformin were most frequently used to manage early hyperglycaemia (<45 days) and PTDM (>45 days). The use of SGLT2 inhibitors and GLP-analogues increased >45 days post-transplantation. Conclusion: This European survey underscores the significant variation in PTDM prevention, screening, and treatment practices, emphasizing the imperative for more explicit guidance in approaching this complication.
dc.format.mimetype application/pdf
dc.identifier.citation Laghrib Y, Hilbrands L, Oniscu GC, Crespo M, Gandolfini I, Mariat C, Mjøen G, Sever MS, Watschinger B, Velioglu A, Demir E, Martinez EG, De Weerd A, Dedinska I, Pippias M, Massart A, Abramowicz D, de Fijter JW, De Block C, Hellemans R. Current practices in prevention, screening, and treatment of diabetes in kidney transplant recipients: European survey highlights from the ERA DESCARTES Working Group. Clin Kidney J. 2024 Dec 10;18(1):sfae367. DOI: 10.1093/ckj/sfae367
dc.identifier.doi http://dx.doi.org/10.1093/ckj/sfae367
dc.identifier.issn 2048-8505
dc.identifier.uri http://hdl.handle.net/10230/71666
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartof Clinical Kidney Journal. 2024;18(1):sfae367
dc.rights © The Author(s) 2024. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.keyword PTDM
dc.subject.keyword Kidney transplantation
dc.subject.keyword Prevention
dc.subject.keyword Screening
dc.subject.keyword Transplant care
dc.title Current practices in prevention, screening, and treatment of diabetes in kidney transplant recipients: European survey highlights from the ERA DESCARTES Working Group
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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