New-onset diabetes mellitus after kidney transplantation: Current status and future directions

Table 3 Management strategies for new-onset diabetes after transplantation

Prevention strategies	Management strategies
Identification of risk factors (Table 1) with pre-transplant counseling	Regular blood glucose monitoring with appropriate follow-up
Pre- and post-transplant screening: random blood glucose, fasting blood glucose, 2-h oral glucose tolerance test with appropriate follow-up	Multi-disciplinary care
Lifestyle modification: weight control, diet, exercise (subject to dialysis-imposed restrictions)	Lifestyle modification: weight control, diet, exercise
Rapid corticosteroid reduction or avoidance	Rapid corticosteroid reduction
Selective calcineurin-inhibitor use (e.g., cyclosporine instead of tacrolimus)	Conversion of cyclosporine to tacrolimus
? Newer immunosuppressive agents (e.g., alemtuzumab, belatacept)	Oral hypoglycemic agents: metformin, sulfonylureas, meglitinides, dipeptidyl peptidase-4 antagonists (alone and/or in combination)
? Magnesium oxide	Insulin
? Statins	Monitoring for complications

?: Requires further investigation.