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

Box 1

WHO and ADA criteria for the diagnosis of diabetes mellitus, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) [16, 17].

The following criteria have been recommended for the diagnosis of diabetes when screening patients for diabetes mellitus after transplant

Symptoms of diabetes plus random plasma glucose concentrations ≥ 200 mg/dl (11.1 mmol/l). Random is defined as any time of day

without regard to time since last meal. The classic symptoms of diabetes include polyuria, polydipsia and unexplained weight loss.

OR

FPG ≥ 126 mg/dl (7.0 mmol/l). Fasting is defined as no caloric intake for at least 8 hours.

OR

2-hour PG ≥ 200 mg/dl (11.1 mmol/l) during an oral glucose tolerance test. The test should be performed as described by WHO,

using a glucose load containing the equivalent of 75 g anhydrous glucose, dissolved in water.

A confirmatory laboratory test based on measurements of plasma glucose should be performed on another day in the absence of

unequivocal hyperglycemia accompanied by acute metabolic decompensation.

Criteria for IFG or IGT

IFG

FPG ≥ 110 mg/dl (6.1 mmol/l) and <126 mg/dl (7.0 mmol/l).

IGT

2-hour PG ≥ 140 mg/dl (7.8 mmol/l) and <200 mg/dl (11.1).

It is important to identify which test is used since the 2-hour OGTT cut-off will identify more people with IGT than those identified

with IFG from the FPG test.

FPG, fasting plasma glucose; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; OGTT, oral glucose tolerance test; PG,

plasma glucose.