Assessment of neuropathy among renal transplant recipients with post-transplant diabetes mellitus: Kuwait experience
Osama Gheith1, Nashwa Othman 2, Torki Al-Otaibi1, Tarek Mahmoud 1, Heba Abduo2, Fatma Mahmoud2, Medhat A Halim1, Ayman Maher1, Faisal Al-Refaei2, Narayanan Nampoory1.
1Nephrology Department, OTC Kuwait, Kuwait, Kuwait; 2Education Department, Dasman Diabetes Institute, Kuwait, Kuwait
Introduction: Diabetic microangiopathies can complicate types 1 and 2 and other secondary forms of diabetes mellitus, including posttransplant diabetes mellitus.
Aim: We aimed to assess the prevalence of neuropathy among renal transplant with post-transplant diabetes.
Materials and Methods: In this cross-sectional study, 210 renal transplants with PTDM were referred from Hamed Al-Essa Organ Transplant Center of Kuwait to Dasman Diabetes Institute for diabetes education. All patients were assessed regarding diabetic neuropathy by nerve conduction (EMG/NC). Patients’ data were collected through patient identification form, results of fundus imaging and EMG/NC studies.
Results: Of 356 (25.6%) kidney transplants with PTDM, 210 cases were enrolled in this study. Most of the patients were Kuwaiti (60%), men (61.9%), and secondary school education level (44.6%). The minority was smokers (11.9%) and the original kidney disease was glomerulonephritis in 37.6% of cases. Most of the patients (71.9%) were hemodialyzed pre-transplant. Cases with variable degrees of proteinuria represented 46.6% (possible diabetic nephropathy) with male predominance (67%). Patients with diabetic neuropathy proven by EMG/NC represented 37% of all cases without significant difference between Kuwaiti or non-Kuwaiti patients but with significant male predominance (63% in males vs.37% in females). Carpal tunnel syndrome was reported among 2.7% of the studied patients. Combined micro-angiopathies were found among 8.8% of patients.
Conclusion: Diabetic neuropathy was not uncommon among renal transplant recipients with PTDM especially Kuwaiti males possibly due to long-standing partially uncontrolled diabetes. Therefore, structured diabetes education is recommended for such a group of patients regarding their lifestyle and blood sugar monitoring.
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