Lung Transplantation and the Development of Diabetes Mellitus in Adult Patients With Cystic Fibrosis

Objective The prevalence of diabetes mellitus is higher in patients with cystic fibrosis than in the general population. Solid organ transplantation is a significant risk factor for diabetes mellitus, which has been linked to type of immunosuppression. The aim of this study was to analyze whether lung transplantation represents a significant risk factor for the onset of abnormal carbohydrate metabolism in cystic fibrosis, whether it affects severity of alterations, and whether there is a relation to type of immunosuppression. Patients and Methods The following data were extracted retrospectively for 54 patients with cystic fibrosis: type of carbohydrate metabolism alteration and treatment received, whether or not transplantation took place, and type of immunosuppression used. Results Twenty of the 54 patients (37%) underwent lung transplantation; 18 of them (89%) developed diabetes mellitus. Eight of the patients (24%) who did not receive a lung developed diabetes and 10 (29%) displayed carbohydrate intolerance (P 2 test). Insulin was administered to 36.3% of nontransplanted patients and 78.6% of transplanted patients. The influence of immunosuppressant used was analyzed in 15 patients. Nine out of 10 patients (90%) treated with cyclosporine and 4 out of 5 (80%) of those treated with tacrolimus developed diabetes mellitus. All received the same regimen of corticosteroid therapy. Conclusions For cystic fibrosis patients, lung transplantation is a significant risk factor for developing abnormal carbohydrate metabolism and it influences severity and treatment. No significant differences in the frequency of development of diabetes mellitus were found in relation to type of immunosuppression.