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dc.contributor.authorUssif, Mohammed Al-Amin
dc.contributor.authorÅsberg, Anders
dc.contributor.authorStrøm Halden, Thea Anine
dc.contributor.authorNordheim, Espen
dc.contributor.authorHartmann, Anders
dc.contributor.authorJenssen, Trond Geir
dc.date.accessioned2019-07-16T11:59:46Z
dc.date.available2019-07-16T11:59:46Z
dc.date.issued2019-01-10
dc.description.abstract<b>Background</b><br> The use of HbA1c ≥6.5% for diagnosis of diabetes has been challenged for post-transplantation diabetes mellitus (PTDM) also known as new onset diabetes after transplantation (NODAT) due to a low sensitivity early after renal transplantation. PTDM diagnosed with an oral glucose tolerance test (OGTT) is highly predictable for long-term patient mortality. HbA1c was introduced for diagnosis based on the risk of developing diabetic retinopathy. The utility of HbA1c measures versus glucose criteria has not been widely assessed in stable transplant patients but still HbA1c is widely used in this population. The aim of the present analyses was to validate the utility of fasting plasma glucose (FPG) together with HbA1c in diagnosing PTDM in stable renal transplant recipients (RTRs).<br><b> Methods</b><br> OGTT’s were performed one year after transplantation in 494 consecutive RTRs without diabetes. FPG and HbA1c were obtained the same day, before starting the OGTT. Validation was performed using C-statistics and logistic regression analyses.<br><b> Results</b><br> PTDM was diagnosed in 51 patients (10.3%) by glucose criteria, 38 (74%) patients were diagnosed by FPG ≥7.0mmol/L [126.1mg/dl], and 13 (26%) only by 2-h plasma glucose. Six of the latter had HbA1c ≥6.5%. Only seven patients out of the 51 (13.7%) PTDM patients remained undiagnosed when HbA1c ≥6.5% was used together with FPG, and five of these regressed to normal after a median follow-up of 14months. ROC curves including FPG and HbA1c versus OGTT derived criteria revealed an AUC of 0.858.<br><b> Conclusions</b><br> Combining standard diagnostic FPG and HbA1c criteria captured almost all patients with persistent PTDM in stable RTRs. The combined use of the criteria appears to be an applicable diagnostic strategy for PTDM without the need of an OGTT one year post-transplant.en_US
dc.description.sponsorshipFrom Internal resources from the Oslo University hospital, Oslo, Norway and analysis was covered by budgets of the involved parties. The funding body had no role at any stage during the preparation of this article.en_US
dc.descriptionPublished version, available at: <a href=https://doi.org/10.1186/s12882-018-1171-3>https://doi.org/10.1186/s12882-018-1171-3</a>en_US
dc.identifier.citationUssif, A.M., Åsberg, A., Halden, T.A. Strøm, Nordheim, E., Hartmann, A., Jenssen, T.G. (2019) Validation of diagnostic utility of fasting plasma glucose and HbA1c in stable renal transplant recipients one year after transplantation.<i> BMC Nephrology, 2019, 20 </i>, 6s. https://doi.org/10.1186/s12882-018-1171-3en_US
dc.identifier.cristinIDFRIDAID 1655444
dc.identifier.doi10.1186/s12882-018-1171-3
dc.identifier.issn1471-2369
dc.identifier.urihttps://hdl.handle.net/10037/15769
dc.language.isoengen_US
dc.publisherSpringer Nature, BMCen_US
dc.relation.isbasedonThe datasets generated and analysed during the current study are not publicly available due to restrictions in Norwegian law, but are available from the corresponding author on reasonable request.en_US
dc.relation.journalBMC Nephrology
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750en_US
dc.titleValidation of diagnostic utility of fasting plasma glucose and HbA1c in stable renal transplant recipients one year after transplantationen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US


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