This document discusses post-transplant diabetes mellitus (PTDM), covering its definition, risk factors, diagnostic criteria, management, and the effects of various immunosuppressive and antidiabetic drugs. It provides questions and answers on topics like the most common cause of end-stage kidney disease in the US, risk factors for PTDM, criteria for diagnosing diabetes and prediabetes, preferred tests for diagnosing diabetes after transplantation, and factors that affect immunosuppressant and antidiabetic drug levels.

1. Post-transplant Diabetes Mellitus:
Questions and Answers
By
Dr. Salwa Mahmoud Elwasif, MD
Fellow of internal medicine and nephrology

3. Most common cause of ESKD in USA
a) Unknown
b) Hypertension
c) Diabetic nephropathy
d) Glomerulonephritis
e) Cystic kidney diseases

4. In spite of being most common cause
of ESKD, diabetic patients have least
prevalence of renal transplantation
a) DM is relative contraindication for renal
transplantation
b) Diabetic nephropathy recurs immediately
after transplantation
c) Other comorbidities associated with DM
d) Diabetic patient must have cadaveric
transplantation for both kidney and pancreas
in type 1 DM

5. Patient survival of diabetic patient is
better than non diabetic after renal
transplantation
a) True
b) False
c) Both are equal

6. Patient survival of diabetic patient is
better with renal transplantation than
dialysis
a) True
b) False
c) Both are equal

7. Graft survival in diabetic patient is
better than non diabetic after
renal transplantation
a) True
b) False
c) Both are equal

8. Criteria for diagnosis of diabetes
a) fasting blood sugar level that is equal to or greater than
126 mg/dL.
b) 2-hour oral glucose tolerance test(OGTT) result that is
equal to or greater than 200 mg/dL.
c) Have a hemoglobin A1c that is 6.5% or higher.
d) symptoms of diabetes and a random blood sugar level
equal to or greater than 200 mg/dL.
e) All of the above

9. Criteria defining prediabetes
a) fasting blood sugar level is 100- 125 mg/dL.
b) 2-hour oral glucose tolerance test(OGTT) is
140- 199 mg/dL.
c) Have a hemoglobin A1c that is 5.7- 6.4%
d) All of the above

10. The preferred test for diagnosis of
DM after organ transplantation is:
a) Fasting plasma glucose
b) HA1c
c) OGTT
d) Frequent plasma glucose measurement
e) Continuous glycemic monitoring

11. The established diagnosis of PTDM by
appearance of hyperglycemia
a) Immediately after organ transplantation in
non diabetic patient.
b) After 1 week
c) After 6 weeks
Transient
hyperglycemia

12. Risk factors for PTDM
1) The lowest diabetogenic immunosuppressive
drug is:
a) CNI
b) MMF
c) mTORi
d) corticosteroids

13. Risk factors for PTDM
2) preexisting factors include:
a) Age above 55years
b) BMI above 30
c) Positive family history

14. Risk factors for PTDM include all the
following except
a) CMV
b) HCV
c) Hypermagnesemia
d) HLA mismatch
e) Hypovitaminosis D

15. ADPCKD is a risk factor for PTDM
a) Common presence of pancreatic cystes
b) Presence of insulin resistance
c) ADPCK needs more diabetogenic
immunosuppressive drugs

16. In experimental model: Tac induced
hyperglycemia is best treated by:
a) Metformin
b) Sulfonylureas
c) SGLT2 I
d) DPP4i

17. Management of diabetes include all
of the following except:
a) Life style modification
b) Mediterranean diet
c) DASH diet
d) Oral hypoglycemic drugs
e) Asprin

18. In experimental model, Recent thymic
emigrant cells
a) Protect against diabetes
b) Diabetogenic
c) No relation with diabetes

19. Treatment of hyperglycemia
immediately posttransplantation
a) Regular insulin
b) Premix insulin
c) Oral hypoglycemic
d) Long acting insulin

20. Cyclosporine increase hypoglycemic
effect of:
a) Metformin
b) Glibenclamide
c) Vildagliptin
d) All of the above

21. Which one of the following drugs
increases the trough level of CNI?
a) Metformin
b) Pioglitazone
c) Vildagliptin
d) All of the above