Table 3.

Screening and treatment of TAHa

ParameterBefore TransplantationPerioperativelyAfter Discharge
Screening75 g OGTT every 1 to 2 yrMultiple daily blood glucose assessmentsWeekly FPG for first month after transplantation
Test for metabolic syndrome components every yearFPG every 4 wk thereafter until 6 mo after transplantation
HCV testingFPG every 8 wk between 6 and 12 mo after transplantation
FPG at least annually after the first posttransplantation year
75 g OGTT at 3 to 6 mo
Annual OGTT after first year
TreatmentbLimit intravenous/oral glucose intakeMedical nutrition therapy
Daily moderate exercise
InsulinWeight loss
Consider meglitinidesMinimize CNI/steroids
Insulin/oral hypoglycemic agents as needed
    TZDs
    meglitinides
    exenatide
Lipid management
  • a TZD, thiazolidinediones.

  • b Glycemic goals are those of American Diabetes Association (35): FPG 90 to 130 mg/dl; 2-h postprandial glucose <180 mg/dl; glycosylated hemoglobin (HbA1c) < 7%.