Othman Nashwa, Gheith Osama, Al-Otaibi Torki, Abdou Heba, Halim Medhat A, Mahmoud Tarek, Nair Prasad, Yagan Jude, Maher Ayman, Dahab Mohamed, Yahya Ahmed
From the Dasman Diabetes Institute, Kuwait and the Faculty of Nursing, Mansoura University, Egypt.
Exp Clin Transplant. 2019 Jan;17(Suppl 1):169-171. doi: 10.6002/ect.MESOT2018.P46.
Posttransplant diabetes is a common complication of solid-organ transplantation. We present the possible role of diabetes education in improvement of posttransplant diabetes in a 36-year-old bodybuilder who was a kidney transplant recipient. The patient had been abusing some medications to help in bodybuilding. He underwent living unrelated-donor renal transplant with thymoglobulin induction and was maintained on steroids, tacrolimus, and mycophenolate mofetil. Posttransplant diabetes was confirmed by blood tests. His blood sugar was partially controlled by 3 oral agents. The patient participated in our structured diabetes education program. This program was created to cover different items related to diabetes control, including diet, proper exercise, blood sugar monitoring, sick day management, and pathophysiologic roles of diabetes medications. Within 4 months of participation in this program, the patient's blood sugar became well controlled and his diabetes medications started to be minimized. He presently has stable graft function with hemoglobin A1c level around 5.6% on only diet management. Bodybuilders are at risk of deterioration of their kidney function. A proper diabetes education program is recommended to help renal transplant recipients with early posttransplant diabetes mellitus to control their disease. Success requires close evaluation and a multidisciplinary approach.
移植后糖尿病是实体器官移植常见的并发症。我们展示了糖尿病教育在改善一名36岁接受肾移植的健美运动员的移植后糖尿病方面可能发挥的作用。该患者曾滥用一些药物来辅助健美。他接受了非亲属活体供肾移植,使用了抗胸腺细胞球蛋白诱导治疗,并维持使用类固醇、他克莫司和霉酚酸酯。通过血液检查确诊为移植后糖尿病。他的血糖通过3种口服药物得到部分控制。该患者参加了我们有组织的糖尿病教育项目。这个项目旨在涵盖与糖尿病控制相关的不同内容,包括饮食、适当运动、血糖监测、患病日管理以及糖尿病药物的病理生理作用。在参加该项目的4个月内,患者的血糖得到了良好控制,并且他的糖尿病药物开始逐渐减少。目前,仅通过饮食管理,他的移植肾功能稳定,糖化血红蛋白水平约为5.6%。健美运动员存在肾功能恶化的风险。建议开展适当的糖尿病教育项目,以帮助早期移植后糖尿病的肾移植受者控制病情。成功需要密切评估和多学科方法。