PDF(Pubmed)
Abstract：
Post-transplantation diabetes mellitus (PTDM) remains a leading complication after solid organ transplantation. Previous international PTDM consensus meetings in 2003 and 2013 provided standardized frameworks to reduce heterogeneity in diagnosis, risk stratification and management. However, the last decade has seen significant advancements in our PTDM knowledge complemented by rapidly changing treatment algorithms for management of diabetes in the general population. In view of these developments, and to ensure reduced variation in clinical practice, a 3rd international PTDM Consensus Meeting was planned and held from 6-8 May 2022 in Vienna, Austria involving global delegates with PTDM expertise to update the previous reports. This update includes opinion statements concerning optimal diagnostic tools, recognition of prediabetes (impaired fasting glucose and/or impaired glucose tolerance), new mechanistic insights, immunosuppression modification, evidence-based strategies to prevent PTDM, treatment hierarchy for incorporating novel glucose-lowering agents and suggestions for the future direction of PTDM research to address unmet needs. Due to the paucity of good quality evidence, consensus meeting participants agreed that making GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) recommendations would be flawed. Although kidney-allograft centric, we suggest that these opinion statements can be appraised by the transplantation community for implementation across different solid organ transplant cohorts. Acknowledging the paucity of published literature, this report reflects consensus expert opinion. Attaining evidence is desirable to ensure establishment of optimized care for any solid organ transplant recipient at risk of, or who develops, PTDM as we strive to improve long-term outcomes.
摘要：
移植后糖尿病（PTDM）仍然是实体器官移植后的主要并发症。2003年和2013年的国际PTDM共识会议提供了减少诊断异质性的标准化框架。风险分层和管理。然而,在过去的十年中,我们在PTDM知识方面取得了显著进步,并在普通人群中迅速改变了糖尿病的治疗算法.鉴于这些发展,并确保减少临床实践中的差异，计划于2022年5月6日至8日在维也纳举行第三次国际PTDM共识会议，奥地利让具有PTDM专业知识的全球代表更新上一份报告。此更新包括有关最佳诊断工具的意见陈述，识别糖尿病前期（空腹血糖受损和/或糖耐量受损），新的机械见解，免疫抑制修饰，预防PTDM的循证策略，纳入新型降糖药物的治疗层次和对PTDM研究未来解决未满足需求的方向的建议。由于缺乏高质量的证据，共识会议参与者一致认为，尽管以同种异体肾移植为中心，但提出GRADE建议将存在缺陷，我们建议移植界可以评估这些意见陈述,以便在不同实体器官移植队列中实施.承认出版文献很少，这种个人观点反映了专家的共识。获得证据是可取的，以确保为任何有风险的实体器官移植受体建立优化的护理，或者发展的人，PTDM，因为我们努力改善长期结果。
