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Journal of Transplantation
Volume 2018, Article ID 1025893, 14 pages
Review Article

Management Strategies for Posttransplant Diabetes Mellitus after Heart Transplantation: A Review

1Faculty of Medicine, St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia
2Heart Failure and Transplant Unit, St Vincent’s Hospital, Sydney, NSW, Australia
3Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
4Department of Endocrinology and Diabetes, St Vincent’s Hospital, Sydney, NSW, Australia
5Diabetes and Metabolism Research Program, Garvan Institute of Medical Research, Sydney, NSW, Australia

Correspondence should be addressed to Peter S. Macdonald; ua.gro.ahvs@dlanodcam.retep

Received 20 October 2017; Accepted 27 December 2017; Published 29 January 2018

Academic Editor: John Paul Scott

Copyright © 2018 Matthew G. Cehic et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Posttransplant diabetes mellitus (PTDM) is a well-recognized complication of heart transplantation and is associated with increased morbidity and mortality. Previous studies have yielded wide ranging estimates in the incidence of PTDM due in part to variable definitions applied. In addition, there is a limited published data on the management of PTDM after heart transplantation and a paucity of studies examining the effects of newer classes of hypoglycaemic drug therapies. In this review, we discuss the role of established glucose-lowering therapies and the rationale and emerging clinical evidence that supports the role of incretin-based therapies (glucagon like peptide- (GLP-) 1 agonists and dipeptidyl peptidase- (DPP-) 4 inhibitors) and sodium-glucose cotransporter 2 (SGLT2) inhibitors in the management of PTDM after heart transplantation. Recently published Consensus Guidelines for the diagnosis of PTDM will hopefully lead to more consistent approaches to the diagnosis of PTDM and provide a platform for the larger-scale multicentre trials that will be needed to determine the role of these newer therapies in the management of PTDM.