Diabetes is an Increasingly Common Issue After Heart Transplantation: A Case for Integrated Diabetes Care.

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart, Lung and Circulation Pub Date : 2025-09-26 DOI:10.1016/j.hlc.2025.04.081

Lisa M Raven, Andrew Jabbour, Peter S Macdonald, Jerry R Greenfield, Christopher A Muir

{"title":"Diabetes is an Increasingly Common Issue After Heart Transplantation: A Case for Integrated Diabetes Care.","authors":"Lisa M Raven, Andrew Jabbour, Peter S Macdonald, Jerry R Greenfield, Christopher A Muir","doi":"10.1016/j.hlc.2025.04.081","DOIUrl":null,"url":null,"abstract":"Background: Orthotopic heart transplantation (OHT) survival rates have improved with advances in immunosuppression over the last 20 years. With these improvements, there has been a greater focus on post-transplant care. Diabetes is common after transplantation and may be pre-existing (type 2 diabetes mellitus [T2DM]) or develop after transplant (post-transplant diabetes mellitus [PTDM]). The aim of this study was to compare the incidence and prevalence of diabetes in OHT recipients in two cohorts separated by 20 years.Methods: Retrospective audit comparing the prevalence of T2DM and cumulative 2-year incidence of PTDM in 88 consecutive OHT recipients in 1996-1998 and 141 consecutive OHT recipients in 2015-2018 at the same tertiary referral teaching hospital.Results: The prevalence of pre-transplant T2DM at the time of OHT increased three-fold between 1998 and 2018, from 6% (n=5) to 18% (n=25) respectively (p=0.009). Similarly, the incidence of PTDM increased from 16% (n=13) in 1998 to 36% (n=42) in 2018 (p=0.001). OHT recipients who developed PTDM were older in 2018 vs 1998 (mean age 52 [±11] vs 44 [±9] years; p=0.03). The mean age was not different between individuals with T2DM between the 1998 and 2018 eras. Body mass index was not different between the 1998 and 2018 eras in any of the diabetes status subgroups.Conclusions: The incidence and prevalence of diabetes after OHT at our Australian institution has increased over 20 years. With improved OHT survival and rates of diabetes, endocrinologists should be incorporated into the care teams of heart transplant recipients. Further studies of glucose-lowering therapies in patients with diabetes after transplantation are warranted.","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart, Lung and Circulation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hlc.2025.04.081","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Orthotopic heart transplantation (OHT) survival rates have improved with advances in immunosuppression over the last 20 years. With these improvements, there has been a greater focus on post-transplant care. Diabetes is common after transplantation and may be pre-existing (type 2 diabetes mellitus [T2DM]) or develop after transplant (post-transplant diabetes mellitus [PTDM]). The aim of this study was to compare the incidence and prevalence of diabetes in OHT recipients in two cohorts separated by 20 years.

Methods: Retrospective audit comparing the prevalence of T2DM and cumulative 2-year incidence of PTDM in 88 consecutive OHT recipients in 1996-1998 and 141 consecutive OHT recipients in 2015-2018 at the same tertiary referral teaching hospital.

Results: The prevalence of pre-transplant T2DM at the time of OHT increased three-fold between 1998 and 2018, from 6% (n=5) to 18% (n=25) respectively (p=0.009). Similarly, the incidence of PTDM increased from 16% (n=13) in 1998 to 36% (n=42) in 2018 (p=0.001). OHT recipients who developed PTDM were older in 2018 vs 1998 (mean age 52 [±11] vs 44 [±9] years; p=0.03). The mean age was not different between individuals with T2DM between the 1998 and 2018 eras. Body mass index was not different between the 1998 and 2018 eras in any of the diabetes status subgroups.

Conclusions: The incidence and prevalence of diabetes after OHT at our Australian institution has increased over 20 years. With improved OHT survival and rates of diabetes, endocrinologists should be incorporated into the care teams of heart transplant recipients. Further studies of glucose-lowering therapies in patients with diabetes after transplantation are warranted.

查看原文本刊更多论文

糖尿病是心脏移植后日益常见的问题：糖尿病综合护理的一个案例。

背景：在过去的20年里，随着免疫抑制技术的进步，原位心脏移植（OHT）的存活率有所提高。随着这些改进，移植后的护理得到了更多的关注。糖尿病在移植后很常见，可能已经存在（2型糖尿病[T2DM]），也可能在移植后发展（移植后糖尿病[PTDM]）。本研究的目的是比较两组间隔20年的OHT接受者中糖尿病的发病率和患病率。方法：回顾性审计比较同一三级转诊教学医院1996-1998年连续接受OHT治疗的88名患者和2015-2018年连续接受OHT治疗的141名患者的T2DM患病率和2年累计PTDM发病率。结果：移植前T2DM在OHT时的患病率在1998年至2018年间增加了三倍，分别从6% （n=5）增加到18% (n=25) （p=0.009）。同样，PTDM的发病率从1998年的16% （n=13）增加到2018年的36% (n=42) （p=0.001）。2018年发生PTDM的OHT受者比1998年更老（平均年龄52[±11]岁比44[±9]岁；p=0.03）。1998年至2018年期间，T2DM患者的平均年龄没有差异。在任何糖尿病状态亚组中，1998年和2018年之间的体重指数没有差异。结论：20年来，我们澳大利亚机构OHT后糖尿病的发病率和患病率有所增加。随着OHT存活率和糖尿病发病率的提高，内分泌科医生应该被纳入心脏移植受者的护理团队。移植后糖尿病患者降糖治疗的进一步研究是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Heart, Lung and Circulation CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.50

自引率

3.80%

发文量

912

审稿时长

11.9 weeks

期刊介绍： Heart, Lung and Circulation publishes articles integrating clinical and research activities in the fields of basic cardiovascular science, clinical cardiology and cardiac surgery, with a focus on emerging issues in cardiovascular disease. The journal promotes multidisciplinary dialogue between cardiologists, cardiothoracic surgeons, cardio-pulmonary physicians and cardiovascular scientists.