In some cases, diabetes can lead to damage that makes an organ transplant necessary. But diabetes isn't only a reason for organ transplants. It can also be the result.
Experts are not certain just how often people develop type 2 diabetes after the transplant of a heart, liver, kidney, lung, or other organ. One review of studies suggested that it could occur in more than one out of 10 people who get a transplant.
For most people, a blister, cut, or scrape on the foot is no big deal -- an "ouch!" and a hurriedly applied bandage, and it's over. Not so if you have diabetes; meticulous daily foot care is as important as monitoring blood glucose, cholesterol, and blood pressure levels.
"Unfortunately, diabetes foot-health awareness doesn't have a colored ribbon or national voice," says foot care expert James Wrobel, DPM, of the University of Michigan Medical School. "If you don't manage them early, small problems...
Diabetes is always a serious illness. But it can have greater risks in people who have had an organ transplant. It raises the danger of organ rejection, dangerous infections, and death. So it's especially important for you to treat -- or preferably prevent -- the condition.
What Causes Diabetes After an Organ Transplant?
Organ transplants are so successful these days because we have better drugs that prevent rejection. Unfortunately, many of the drugs used to suppress the immune system -- such as the medication Prograf (tacrolimus) or corticosteroids -- can cause diabetes or make it worse.
Drugs aren't the only cause. Other risk factors are:
A family history of the diabetes
Being black or Latino
Being older than age 40
Having hepatitis C
Treatment for Diabetes After an Organ Transplant
The good news is that diabetes after an organ transplant may not be lasting, says Barry Friedman, RN, administrative director of the Solid Organ Transplant Program at the Children's Medical Center in Dallas. It may go away if you change or reduce your medication dosage. Many people can stop taking steroids after six months or so. This may solve the problem.
In some cases, you may need medicine to treat the diabetes. Lifestyle changes can make a difference, too. They include:
Eating a healthy diet
Keeping good control of your blood sugar
Getting regular medical care
Talk to your health care provider if you think that you're at high risk of getting diabetes. He or she may be able to prescribe medicines that are less likely to cause the condition.
Getting diabetes after an organ transplant can be scary. It also adds further hassles to your everyday life. You'll have to watch what you eat and check your blood sugars regularly. But you'll get used to it. Being careful and taking control of your condition makes a huge difference.
Barry Friedman, RN, administrative director of the Solid Organ Transplant Program, Children's Medical Center, Dallas; former president of the North American Transplant Coordinators Organization. Richard Perez, MD, PhD, director of the Transplant Center, professor in the Department of Surgery, University of California Medical Center at Davis. Jeffrey D. Punch, MD, associate professor of Surgery, chief of the Division of Transplantation, director of the Liver Transplant Program, University of Michigan Health System, Ann Arbor. National Kidney Foundation web site. United Network for Organ Sharing web site. United Network for Organ Sharing's "Transplant Living" web site. U.S. Department of Health and Human Services, "Partnering with Your Transplant Team: The Patient's Guide to Transplantation, 2004." Bihl,G. Dialysis and Transplantation, 2004; vol 33: pp 244-249. Carithers, R. "Liver and Pancreas Transplantation," ACP Medicine, November 2003. Heisel, O. American Journal of Transplantation, 2004; vol 4: 583-595. Klassen, D. "Renal Transplantation," ACP Medicine, January 2002. Sievers, M. Transplant Trends, 2003; vol 5: pp 190-209.
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