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Dialysis Discussion => Dialysis: Transplant Discussion => Topic started by: Whamo on March 24, 2018, 03:28:23 PM

Title: Do transplants make everyone diabetic?
Post by: Whamo on March 24, 2018, 03:28:23 PM
My wife told me this yesterday.  I was skeptical, but I figured the people on this thread would know.
Title: Re: Do transplants make everyone diabetic?
Post by: MooseMom on March 24, 2018, 03:47:59 PM
No.
Title: Re: Do transplants make everyone diabetic?
Post by: Michelle2016 on March 24, 2018, 06:58:58 PM
Not me.
Title: Re: Do transplants make everyone diabetic?
Post by: iolaire on March 24, 2018, 07:40:36 PM
No but on high doses of prednisone you may have drug induced diabetes. I had to measure my blood sugars for about a month and then stopped. During that time I was borderline.
Title: Re: Do transplants make everyone diabetic?
Post by: Paul on March 25, 2018, 03:03:49 AM
Can do the opposite. When they give diabetics a new kidney they sometimes replace the pancreas at  the same time, "curing" their diabetes.
Title: Re: Do transplants make everyone diabetic?
Post by: UkrainianTracksuit on March 25, 2018, 03:35:51 AM
Can do the opposite. When they give diabetics a new kidney they sometimes replace the pancreas at  the same time, "curing" their diabetes.
Some clarifications needed here.

The pancreas is not "replaced" but rather the donor pancreas is attached to the recipient's bowel. (Used to be more common to be attached to the bladder, this still happens, but not as before.) The native pancreas remains to perform digestive functions and the transplanted one puts out insulin. Definitely not a replacement.

Second point is that Type I diabetic patients can develop Type II drug induced diabetes from prednisone and tacrolimus. This is why exercise, healthy eating and weight control is stressed a lot for diabetic patients. The few insulin dependent Type II diabetics that receive pancreatic transplants can find themselves with drug induced Type II afterwards as well. It can be reversed but there remains the chance of these patients returning to using insulin.
Title: Re: Do transplants make everyone diabetic?
Post by: MooseMom on March 25, 2018, 08:38:54 AM
Whamo, to elaborate on iolaire's point, pred and myfortic can cause drug induced diabetes, but the risks are mitigated if those drugs are taken with food.

To illustrate, from the very beginning, my tx neph told me that she was not concerned about me developing diabetes.  I guess they can tell who might have a problem and who will not.

I get labs done every month and have my glucose checked.  I've never had high blood sugar in the almost 6 years I've been transplanted.

But one month a few years ago, I ate some pico de gallo over the course of several days.  It must have been bad because I got a bit ill.  I couldn't keep any food down for 3 days, but I did keep taking my meds.  On Sunday night, I threw up everything in my stomach, and I felt better!  That was the end of that!

Monday morning I was scheduled to get labs done, and I managed to pull my butt out of bed and get to the lab.

When I got my results, my blood sugar was elevated for the first time EVER, and I knew it was because I took my meds but didn't have any food.

Bottom line, the meds CAN mess with your blood sugar, but that doesn't mean you'll become diabetic.

I hope this helps.
Title: Re: Do transplants make everyone diabetic?
Post by: cattlekid on March 25, 2018, 12:08:37 PM
My fasting glucose started to creep up into the 130's a couple of years post transplant.  I am on prednisone, but only 5 mg daily.  I did lose 20 lbs right away after transplant but put it back on along with 30 of its friends.  So I knew I had to do something.  Dr. sent me for diabetes education and I started watching my carbs more closely.  Lost 15 lbs and now blood sugars stay in the 110-120 range.  Still elevated but below the Type 2 diabetes threshold.  Am still working on losing weight so I assume the more weight I can lose, the closer to normal I will get.   
Title: Re: Do transplants make everyone diabetic?
Post by: Simon Dog on March 25, 2018, 01:05:11 PM
Prednisone can induce AVN of the hip necessitating replacement.  It happened to me (prescribed for a non-transplant reason), and I have met one transplant patient who had to have both hips done because of Prednisone induced AVN.

Oral steroids create a risk, but not certainty, of diabetes.  It's just one of the things that goes with the territory.
Title: Re: Do transplants make everyone diabetic?
Post by: PrimeTimer on March 25, 2018, 10:46:46 PM
But one month a few years ago, I ate some pico de gallo over the course of several days.  It must have been bad because I got a bit ill.  I couldn't keep any food down for 3 days, but I did keep taking my meds.  On Sunday night, I threw up everything in my stomach, and I felt better!  That was the end of that!

Monday morning I was scheduled to get labs done, and I managed to pull my butt out of bed and get to the lab.

When I got my results, my blood sugar was elevated for the first time EVER, and I knew it was because I took my meds but didn't have any food.

Bottom line, the meds CAN mess with your blood sugar, but that doesn't mean you'll become diabetic.

I hope this helps.

When you get sick (vomiting) this puts stress on your regulatory hormones and can cause them to go into the "flight or fight" mode and say "hurry, respond to the emergency!" I don't have diabetes but once was so sick that my blood sugar level was at 183. That was crazy for me because I'm usually closer to 70-90. Hubby called the paramedics that time.

As for Prednisone, I had to take Prednisone long term to treat Polymyositis. They did a base line ultra sound of my liver and then blood tests every few weeks and more ultra sounds to avoid me from getting diabetes. They said if I did get diabetes it would probably only be temporary and stop once I stopped the Prednisone. But I have a friend who had gestational diabetes only her hormones did not return to normal after having her baby. She ended up with diabetes permanently and having to use Insulin.