Diabetes (also known as diabetes mellitus) is a lifelong condition where the body cannot use glucose (a type of sugar) correctly. Glucose is moved from the bloodstream and into the cells by the hormone insulin (produced by the pancreas), where it provides energy for the cells to work. In patients with diabetes, either the cells of the pancreas that produce insulin are destroyed by the immune system (type 1 diabetes), not enough insulin is produced by the pancreas, or the cells in the body are resistant to insulin (both known as type 2 diabetes). This results in high blood glucose levels.
It is important to take steps to prevent diabetes where possible, and to spot it early so that blood glucose levels can be carefully controlled. If diabetes is not adequately controlled, it can cause lasting damage to blood vessels, affecting the cardiovascular system, nerves, eyes and kidneys.
Why are transplant recipients at risk of diabetes?
Up to 40% of people who have had a solid organ transplant are thought to develop diabetes after transplantation (also known as new onset diabetes after transplantation; NODAT).
There are several reasons that diabetes might develop in the general population, such as being overweight, and these apply to transplant recipients too. Additionally, the anti-rejection drugs (immunosuppressants) that are essential to prevent rejection of the transplanted organ can increase the chance of developing diabetes. NODAT can be caused by both not enough insulin being produced (similar to type 1 diabetes) and by the cells not responding properly to the insulin (similar to type 2 diabetes). This means that the way post-transplant diabetes is managed might be different to the way the other types of diabetes are managed and it is important to follow any advice given by your transplant team.
How is diabetes diagnosed?
Symptoms of diabetes include feeling particularly thirsty, urinating more often than usual, feeling tired and losing weight. If you notice any of these symptoms, discuss them with your transplant team straight away. Diabetes can be diagnosed by a test to measure the amount of glucose in the bloodstream.
How can diabetes be prevented?
There are some risk factors that cannot be changed, such as your ethnicity, age and family history of diabetes. However, being overweight is a significant risk factor for developing diabetes, particularly if the excess weight is around your middle. You should try to maintain a healthy weight by eating a balanced diet and exercising regularly; this can minimise your risk of developing diabetes, as well as bringing many other health benefits.
If you have already been diagnosed with diabetes, it is important that you take any medications you have been prescribed to managed this condition as well as following any lifestyle advice you have been given.