Expert consensus on the use of hypoglycemic drugs in post transplantation diabetes mellitus (2024 edition)
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摘要: 近年来有关器官移植后糖尿病（PTDM）诊治的临床证据日益增多，尤其是新型降糖药和血糖监测新技术的不断问世，进一步推动了PTDM的诊治进展。为详细阐述降糖药物在PTDM中的应用，中国研究型医院学会糖尿病学专业委员会、中华医学会糖尿病学分会与北京医学会糖尿病学分会共同组织专家编写了《实体器官移植后糖尿病患者降糖药物应用专家共识（2024版）》，共识主要围绕降糖药物的降糖作用机制、推荐强度、临床应用注意事项及其与免疫抑制剂的相互作用等方面展开，以期进一步提高临床对PTDM患者的管理水平，改善其结局。该共识的发布将有助于规范PTDM的临床诊疗。Abstract: In recent years, increasing clinical evidence has been accumulated to support the diagnosis and treatment of post transplantation diabetes mellitus (PTDM), especially the advent of novel hypoglycemic drugs and glucose monitoring technologies, which further promotes the advancement of diagnosis and treatment of PTDM. To elaborate the use of hypoglycemic drugs in PTDM, Diabetology Committee of Chinese Research Hospital Association, Chinese Diabetes Society and Diabetes Branch of Beijing Medical Association jointly organized relevant experts to compile Expert consensus on the use of hypoglycemic drugs in post transplantation diabetes mellitus (2024 Edition), which mainly focuses on the hypoglycemic mechanism, recommended intensity, cautions in clinical application and the interaction with immunosuppressants, aiming to further enhance clinical management level for PTDM patients and improve clinical outcomes. The release of this expert consensus will contribute to standardizing clinical diagnosis and treatment of PTDM.
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Key words:
- Diabetes mellitus /
- Post transplantation /
- Hypolycemic drug /
- Consensus /
- Treatment
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表 1 英国牛津大学循证医学中心证据分级与推荐标准[1]
Table 1. Evidence classification and recommendation criteria of Oxford Center of Evidence-Based Medicine
推荐强度 证据级别 描述 A 1a 同质RCT的SR 1b 单个RCT研究 1c “全或无”证据（有治疗以前，所有患者都死亡；有治疗之后，有患者能存活。或者在有治疗之前，一些患者死亡；有治疗之后，无患者死亡） B 2a 基于队列研究的SR（有同质性） 2b 单个队列研究（包括低质量RCT，如<80%随访） 3a 基于病例对照研究的SR（有同质性） 3b 单个病例对照研究 C 4 病例报告（低质量队列研究） D 5 专家意见或评论 注：RCT为随机对照试验；SR为系统评价；推荐强度中，A为推荐，B为应当考虑，C为可以考虑，D为不推荐。 
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表 2 本共识推荐意见汇总一览表
Table 2. Summary table of recommended opinions in this consensus
推荐意见序号 推荐内容 推荐强度 证据级别 1 PTDM患病率高，危害严重，增加移植物功能丧失及感染风险，严重影响移植受者的长期生存，需要高度关注。应注重筛查，及时诊断，全程随访管理 A 2a 2 PTDM常合并多重心血管疾病危险因素，包括高血压、血脂紊乱、高尿酸血症、肥胖、慢性肾功能不全等，应对PTDM患者易并发的ASCVD多重危险因素进行筛查、评估及综合管理，以提高其长期生存率及生活质量 A 2a 3 PTDM的诊断需在免疫抑制剂维持治疗阶段、无应激、移植物功能稳定状态（>术后45 d）下进行，不包括术前已诊断的糖尿病及术后一过性高血糖。诊断标准同WHO糖尿病诊断标准，不建议单独使用HbA1c诊断PTDM，特别是移植术后1年内 B 2a 4 建议所有成人移植受者在移植前与移植后均进行糖代谢筛查，筛查方式有AGM（糖皮质激素服药后7~8 h）、FPG、HbA1c、OGTT等 A 2b 5 建议应用SMBG作为器官移植受者糖代谢常规筛查手段。尤其应重视AGM的检测，在移植术后早期（≤术后45 d），AGM用于筛查糖代谢异常的灵敏度优于FPG。HbA1c不适用于血红蛋白异常的移植受者。OGTT是诊断糖代谢异常的金标准，尤其适用于其他筛查方法提示的糖代谢异常患者或者可疑PTDM患者 A 1b 6 血糖筛查频率：建议在移植术后早期（≤术后45 d）每日至少进行1次SMBG，优先推荐AGM检测，术后3、6、12个月各进行1次SMBG联合HbA1c筛查。此后每年进行至少1次上述筛查，对于高危受者应增加血糖监测频次，必要时进行OGTT筛查 A 2b 7 移植后稳定期（>术后45 d）血糖控制目标如下，在避免低血糖的情况下，FPG<7.0 mmol/L，2hPG<10.0 mmol/L，HbA1c<7.0%；控制目标应考虑受者年龄、糖尿病合并症/并发症、低血糖发生风险、预期寿命和主观意愿等 B 1c 8 PTDM 患者均需进行SMBG，监测频次参考成人2 型糖尿病监测原则；根据个体情况，每3~6个月对HbA1c进行检测 B 2b 9 CGM可应用于血糖波动大、存在无法解释的高血糖、反复发作低血糖或降糖方案/抗排斥方案调整阶段的移植受者 B 1c 10 生活方式干预是PTDM管理的基础，对单纯生活方式干预后血糖仍不达标者，应当考虑联合降糖药物治疗 A 2b 11 二甲双胍可用于PTDM的治疗，包括肾移植受者、心脏移植受者和肝移植
受者肾移植B；心脏移植A；肝移植A 肾移植2a；心脏移植2a；肝移植2b 12 二甲双胍应用于PTDM患者可降低肾移植受者移植物功能丧失风险、全因死亡率和急性排斥反应的发生，可降低心脏移植受者移植心脏血管病变和恶性肿瘤的发生风险，且不增加乳酸酸中毒的风险 A 2a 13 瑞格列奈可用于PTDM患者的治疗，包括肾移植受者、肝移植受者 B 肾移植1b；肝移植2b 14 DPP-4i可用于肾移植受者PTDM的治疗，如西格列汀、维格列汀、利格列汀 A 西格列汀1a；维格列汀1b；利格列汀2a 15 SGLT2i可用于PTDM患者的治疗，包括肾移植受者、心脏移植受者、肝移植受者和肺移植受者 肾移植B；心脏移植B；肝移植B；肺移植C 肾移植1a；心脏移植2a；肝移植2b；肺移植4 16 GLP-1RA可用于PTDM患者的治疗，包括肾移植受者、心脏移植受者、肝移植受者和肺移植受者 肾移植B；心脏移植B；肝移植B；肺移植C 肾移植2a；心脏移植2a；肝移植2b；肺移植4 17 存在以下情况时建议起始胰岛素治疗，在生活方式和非胰岛素降糖药治疗的基础上，血糖仍未达标者；合并应激状态，如重症感染、手术等；诊断PTDM时HbA1c≥9.0%或FPG≥11.1 mmol/L，同时伴明显高血糖症状者；PTDM合并消瘦或营养不良者 B 1c 18 胰岛素的治疗必须高度个体化，包括不同胰岛素治疗方案的选择、起始剂量、剂量调整等 B 1c 注：ASCVD为动脉粥样硬化性心血管疾病；HbA1c为糖化血红蛋白；AGM为午后血糖监测；FPG为空腹血糖；OGTT为口服葡萄糖耐量试验；SMBG为自我血糖监测；2hPG为餐后2 h血糖；CGM为持续葡萄糖监测；DPP-4i为二肽基肽酶Ⅳ抑制剂；SGLT2i为钠-葡萄糖共转运蛋白2抑制剂；GLP-1RA为胰高糖素样肽-1受体激动剂。
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表 3 常用胰岛素及其作用特点[25]
Table 3. Common insulin and its characteristics of action
类别 胰岛素制剂 起效时间 峰值时间 作用持续时间（h） 餐时胰岛素 短效人胰岛素（RI） 15~60 min 2~4 h 5~8 超短效胰岛素类似物 门冬胰岛素 10~15 min 1~2 h 4~6 赖脯胰岛素 10~15 min 1~1.5 h 4~5 谷赖胰岛素 10~15 min 1~2 h 4~6 基础胰岛素 中效人胰岛素（NPH） 2.5~3 h 5~7 h 13~16 长效胰岛素（PZI） 3~4 h 8~10 h 20 长效胰岛素类似物 地特胰岛素 3~4 h 3~14 h 24 甘精胰岛素U100 2~3 h 无峰 30 超长效胰岛素类似物 德谷胰岛素 1 h 无峰 42 甘精胰岛素U300 6 h 无峰 36 预混胰岛素 预混人胰岛素（30R，70/30） 0.5 h 2~12 h 14~24 预混人胰岛素（40R） 0.5 h 2~8 h 24 预混人胰岛素（50R） 0.5 h 2~3 h 10~24 预混胰岛素类似物 门冬胰岛素30 10~ 20 min 1~4 h 14~24 门冬胰岛素50 15 min 30~70 min 16~24 赖脯胰岛素25 15 min 30~70 min 16~24 赖脯胰岛素50 15 min 30~70 min 16~24 双胰岛素 德谷门冬双胰岛素70/30 10~15 min 1.2 h > 24 注：甘精胰岛素U100是指胰岛素含量100 U/mL，甘精胰岛素U300指胰岛素含量300 U/mL；预混人胰岛素（30R，70/30）含30%短效胰岛素和70%中效胰岛素；预混人胰岛素（40R）含40%短效胰岛素和60%中效胰岛素；预混人胰岛素（50R）含50%中效胰岛素和50%短效胰岛素；门冬胰岛素30含30%门冬胰岛素和70%精蛋白门冬胰岛素；门冬胰岛素50含50%精蛋白门冬胰岛素和50%门冬胰岛素；赖脯胰岛素25含25%赖脯胰岛素和75%精蛋白锌赖脯胰岛素；赖脯胰岛素50含50%赖脯胰岛素和50%精蛋白锌赖脯胰岛素；德谷门冬双胰岛素70/30含70%德谷胰岛素和30%门冬胰岛素。因受胰岛素剂量、吸收、降解等多种因素的影响，且个体差异大，表中胰岛素作用时间仅供参考。
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1 非胰岛素降糖药物在PTDM应用的临床研究及证据等级汇总
降糖药物种类 研究出处 代表药物 移植器官 患者数 研究设计 证据等级 双胍类 Vest等[31]（2018年） 二甲双胍 肾移植 14 144 回顾性队列研究 2a Kwon等[32]（2023年） 二甲双胍 肾移植 1 193 回顾性队列研究 2b Ram等[33]（2019年） 二甲双胍 心脏移植 103 前瞻性队列研究 2a Bedanova等[34]（2021年） 二甲双胍 心脏移植 497 回顾性队列研究 2b Peled等[35]（2017年） 二甲双胍 心脏移植 237 前瞻性队列研究 2a TZD Kharazmkia等[40]（2014年） 吡格列酮 肾移植 62 随机对照试验 1b Arashnia等[41]（2015年） 吡格列酮 肾移植 58 随机对照试验 1b 非磺脲类促泌剂 闫赋琴等[42]（2016年） 瑞格列奈 肾移植 32 回顾性队列研究 2b Niu等[43]（2013年） 瑞格列奈 肝移植 86 前瞻性队列研究 2b DPP-4i Lane等[46]（2011 年） 西格列汀 肾移植 15 回顾性队列研究 3b Sanyal等[51]（2013 年） 利格列汀 肾移植 21 回顾性队列研究 3b Attallah 和Yassine[52]（2021年） 利格列汀 肾移植 42 回顾性队列研究 2b Boerner等[47]（2014年） 西格列汀 肾移植 22 回顾性队列研究 3b Haidinger等[50]（2014 年） 维格列汀 肾移植 32 随机对照试验 1b Strøm Halden等[48]（2014年） 西格列汀 肾移植 19 随机对照研究 1b Bae等[56]（2016年） 维格列汀、西格列汀、利格列汀 肾移植 65 回顾性队列研究 3b Soliman等[49]（2013 年） 西格列汀 肾移植 45 随机对照研究 1b SGLT2i Chewcharat等[57]（2020年） 恩格列净、卡格列净、达格列净 肾移植 132 系统评价和荟萃分析 1b Oikonomaki等[58]（2021年） 卡格列净、恩格列净、达格列净 肾移植 310 系统评价和荟萃分析 1b Halden等[59]（2019年） 恩格列净 肾移植 44 随机对照试验 1b Lim等[60]（2022年） SGLT2ia 肾移植 2 083（使用SGLT2i者226例，未用者1 857例） 回顾性队列研究 2b Sánchez Fructuoso等[61]（2023年） 恩格列净、达格列净、卡格列净 肾移植 339 多中心队列研究 2b Hisadome等[62]（2021年） SGLT2i 肾移植 89 回顾性队列研究 2b Cehic等[63]（2019 年） 恩格列净 心脏移植 22 回顾性队列研究 2b Sammour等[64]（2021年） 恩格列净、卡格列净、达格列净 心脏移植 21 回顾性队列研究 2b Cha等[65]（2021年） 达格列净 心脏移植 1 病例报告 4 Sweiss等[66]（2023年） SGLT2i 肝、肾、肺、肝-肾联合移植 49 回顾性队列研究 2b GLP-1RA Halden等[67]（2016年） GLP-1 肾移植 24 随机对照试验 1b Singh等[68]（2020年） 度拉糖肽、
利拉鲁肽肾、肝、肝-肾联合移植、心脏移植 88 回顾性队列研究 2b Kim等[69]（2021年） 度拉糖肽 肾移植 36 回顾性队列研究 2b Thangavelu等[70]（2020年） GLP-1RA 肾、肝、心脏移植 19 回顾性队列研究 2b Singh等[71]（2019年） 度拉糖肽 肾、肝、肝-肾联合移植、心脏移植 63 回顾性队列研究 2b Sweiss等[72]（2022年） GLP-1RA 肾、肝、肺移植 118 回顾性队列研究 2b Kukla等[73]（2020年） 利拉鲁肽、度拉糖肽、艾塞那肽 肾移植 17 回顾性病例系列研究 4 Yugueros González等[74]（2021年） 司美格鲁肽、利拉鲁肽、度拉糖肽 肾移植 15 回顾性病例系列研究 4 Sato等[75]（2023年） GLP-1RA 肾移植 73 回顾性队列研究 2b Oikonomaki等[58]（2021年） SGLT2i（卡格列净、恩格列净、达格列净）/DPP4/GLP-1RA（利拉鲁肽、艾塞那肽、度拉
糖肽）肾移植 310 系统评价和荟萃分析 1b 注：PTDM为器官移植后糖尿病；TZD为噻唑烷二酮类；DPP-4i为二肽基肽酶Ⅳ抑制剂；SGLT2i为钠-葡萄糖共转运蛋白2抑制剂；GLP-1RA为胰高糖素样肽-1受体激动剂；GLP-1为胰高糖素样肽-1；DPP4为二肽基肽酶Ⅳ。
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[1] Oxford centre for evidence-based medicine levels of evidence[EB/OL]. [2024-01-10].https://www.docin.com/ p-776102919.html. [2] MONTORI VM, BASU A, ERWIN PJ, et al. Posttransplantation diabetes: a systematic review of the literature[J]. Diabetes Care, 2002, 25(3): 583-592. DOI: 10.2337/diacare.25.3.583. [3] CHAMBERS DC, PERCH M, ZUCKERMANN A, et al. The international thoracic organ transplant registry of the International Society for Heart and Lung Transplantation: thirty-eighth adult lung transplantation report—2021; focus on recipient characteristics[J]. J Heart Lung Transplant, 2021, 40(10): 1060-1072. DOI: 10.1016/j.healun.2021.07.021. [4] NEWMAN JD, SCHLENDORF KH, COX ZL, et al. Post-transplant diabetes mellitus following heart transplantation[J]. J Heart Lung Transplant, 2022, 41(11): 1537-1546. DOI: 10.1016/j.healun.2022.07.011. [5] LINDER KE, BAKER WL, ROCHON C, et al. Evaluation of posttransplantation diabetes mellitus after liver transplantation: assessment of insulin administration as a risk factor[J]. Ann Pharmacother, 2016, 50(5): 369-375. DOI: 10.1177/1060028015627662. [6] JENSSEN T, HARTMANN A. Post-transplant diabetes mellitus in patients with solid organ transplants[J]. Nat Rev Endocrinol, 2019, 15(3): 172-188. DOI: 10.1038/s41574-018-0137-7. [7] AHMED SH, BIDDLE K, AUGUSTINE T, et al. Post-transplantation diabetes mellitus[J]. Diabetes Ther, 2020, 11(4): 779-801. DOI: 10.1007/s13300-020-00790-5. [8] BEE YM, TAN HC, TAY TL, et al. Incidence and risk factors for development of new-onset diabetes after kidney transplantation[J]. Ann Acad Med Singap, 2011, 40(4): 160-167. DOI: 10.47102/annals-acadmedsg.V40N4 p160. [9] YEH H, LIN C, LI YR, Et al. Temporal trends of incident diabetes mellitus and subsequent outcomes in patients receiving kidney transplantation: a national cohort study in Taiwan[J]. Diabetol Metab Syndr, 2020, 12: 34. DOI: 10.1186/s13098-020-00541-3. [10] LIM WH, LOK CE, KIM SJ, et al. Impact of pretransplant and new-onset diabetes after transplantation on the risk of major adverse cardiovascular events in kidney transplant recipients: a population-based cohort study[J]. Transplantation, 2021, 105(11): 2470-2481. DOI: 10.1097/TP.0000000000003639. [11] SHARIF A, HECKING M, DE VRIES AP, et al. Proceedings from an international consensus meeting on posttransplantation diabetes mellitus: recommendations and future directions[J]. Am J Transplant, 2014, 14(9): 1992-2000. DOI: 10.1111/ajt.12850. [12] American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: standards of care in diabetes—2024[J]. Diabetes Care, 2024, 47(Suppl 1): S20-S42. DOI: 10.2337/dc24-S002. [13] SENIOR PA, ALMEHTHEL M, MILLER A, et al. Diabetes and transplantation[J]. Can J Diabetes, 2018, 42(Suppl 1): S145-S149. DOI: 10.1016/j.jcjd.2017.10.017. [14] XIA M, YANG H, TONG X, et al. Risk factors for new-onset diabetes mellitus after kidney transplantation: a systematic review and meta-analysis[J]. J Diabetes Investig, 2021, 12(1): 109-122. DOI: 10.1111/jdi.13317. [15] SUAREZ O, PARDO M, GONZALEZ S, et al. Diabetes mellitus and renal transplantation in adults: is there enough evidence for diagnosis, treatment, and prevention of new-onset diabetes after renal transplantation?[J]. Transplant Proc, 2014, 46(9): 3015-3020. DOI: 10.1016/j.transproceed.2014.07.011. [16] CHEUNGPASITPORN W, THONGPRAYOON C, VIJAYVARGIYA P, et al. The risk for new-onset diabetes mellitus after kidney transplantation in patients with autosomal dominant polycystic kidney disease: a systematic review and meta-analysis[J]. Can J Diabetes, 2016, 40(6): 521-528. DOI: 10.1016/j.jcjd.2016.03.001. [17] DAVIDSON J, WILKINSON A, DANTAL J, et al. New-onset diabetes after transplantation: 2003 international consensus guidelines[J]. Transplantation, 2003, 75(10 Suppl): SS3-SS24. DOI: 10.1097/01.TP.0000069952.49242.3E. [18] YATES CJ, FOURLANOS S, COLMAN PG, et al. Screening for new-onset diabetes after kidney transplantation: limitations of fasting glucose and advantages of afternoon glucose and glycated hemoglobin[J]. Transplantation, 2013, 96(8): 726-731. DOI: 10.1097/TP.0b013e3182a012f3. [19] YATES CJ, FOURLANOS S, COLMAN PG, et al. Divided dosing reduces prednisolone-induced hyperglycaemia and glycaemic variability: a randomized trial after kidney transplantation[J]. Nephrol Dial Transplant, 2014, 29(3): 698-705. DOI: 10.1093/ndt/gft377. [20] SCHWAIGER E, KRENN S, KURNIKOWSKI A, et al. Early postoperative basal insulin therapy versus standard of care for the prevention of diabetes mellitus after kidney transplantation: a multicenter randomized trial[J]. J Am Soc Nephrol, 2021, 32(8): 2083-2098. DOI: 10.1681/ASN.2021010127. [21] DOS SANTOS Q, HORNUM M, TERRONES-CAMPOS C, et al. Posttransplantation diabetes mellitus among solid organ recipients in a danish cohort[J]. Transpl Int, 2022, 35: 10352. DOI: 10.3389/ti.2022.10352. [22] SHARIF A, CHAKKERA H, DE VRIES APJ, et al. International consensus on post-transplantation diabetes mellitus [EB/OL]. [2024-01-10].https://pubmed. ncbi.nlm.nih.gov/38171510/. [23] INZUCCHI SE, BERGENSTAL RM, BUSE JB, et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)[J]. Diabetes Care, 2012, 35(6): 1364-1379. DOI: 10.2337/dc12-0413. [24] SHEN T, ZHUANG L, SUN XD, et al. Expert consensus on management of metabolic disease in Chinese liver transplant recipients[J]. World J Gastroenterol, 2020, 26(27): 3851-3864. DOI: 10.3748/wjg.v26.i27.3851. [25] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020 年版)[J]. 中华糖尿病杂志, 2021, 13(4): 315-409. DOI: 10.3760/cma.j.cn115791-20210221-00095.Branch of Diabetes of Chinese Medical Association. Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition)[J]. Chin J Diabetes, 2021, 13(4): 315-409. DOI: 10.3760/cma.j.cn115791-20210221-00095. [26] LU J, MA X, ZHOU J, et al. Association of time in range, as assessed by continuous glucose monitoring, with diabetic retinopathy in type 2 diabetes[J]. Diabetes Care, 2018, 41(11): 2370-2376. DOI: 10.2337/dc18-1131. [27] BECK RW, BERGENSTAL RM, RIDDLESWORTH TD, et al. Validation of time in range as an outcome measure for diabetes clinical trials[J]. Diabetes Care, 2019, 42(3): 400-405. DOI: 10.2337/dc18-1444.h. [28] KRISTENSEN K, ÖGGE LE, SENGPIEL V, et al. Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of 186 pregnancies[J]. Diabetologia, 2019, 62(7): 1143-1153. DOI: 10.1007/s00125-019-4850-0. [29] LU J, WANG C, SHEN Y, et al. Time in range in relation to all-cause and cardiovascular mortality in patients with type 2 diabetes: a prospective cohort study[J]. Diabetes Care, 2021, 44(2): 549-555. DOI: 10.2337/dc20-1862. [30] 中华医学会糖尿病学分会. 中国血糖监测临床应用指南(2021年版)[J]. 中华糖尿病杂志, 2021, 13(10): 936-948. DOI: 10.3760/cma.j.cn115791-20210810-00436.Branch of Diabetes of Chinese Medical Association. Clinical application guideline for blood glucose monitoring in China (2021 edition)[J]. Chin J Diabetes, 2021, 13(10): 936-948. DOI: 10.3760/cma.j.cn115791-20210810-00436. [31] VEST LS, KORAISHY FM, ZHANG Z, et al. Metformin use in the first year after kidney transplant, correlates, and associated outcomes in diabetic transplant recipients: a retrospective analysis of integrated registry and pharmacy claims data[J]. Clin Transplant, 2018, 32(8): e13302. DOI: 10.1111/ctr.13302. [32] KWON S, KIM YC, KWON H, et al. Metformin use and long-term clinical outcomes in kidney transplant recipients[J]. Am J Kidney Dis, 2023, 82(3): 290-299. DOI: 10.1053/j.ajkd.2023.01.446. [33] RAM E, LAVEE J, TENENBAUM A, et al. Metformin therapy in patients with diabetes mellitus is associated with a reduced risk of vasculopathy and cardiovascular mortality after heart transplantation[J]. Cardiovasc Diabetol, 2019, 18(1): 118. DOI: 10.1186/s12933-019-0925-y. [34] BEDANOVA H, HORVATH V, ONDRASEK J, et al. Metformin therapy and risk of cancer in patients after heart transplantation[J]. Bratisl Lek Listy, 2021, 122(5): 305-309. DOI: 10.4149/BLL_2021_051. [35] PELED Y, LAVEE J, RAICHLIN E, et al. Metformin therapy reduces the risk of malignancy after heart transplantation[J]. J Heart Lung Transplant, 2017, 36(12): 1350-1357. DOI: 10.1016/j.healun.2017.06.009. [36] CROWLEY MJ, DIAMANTIDIS CJ, MCDUFFIE JR, et al. Clinical outcomes of metformin use in populations with chronic kidney disease, congestive heart failure, or chronic liver disease: a systematic review[J]. Ann Intern Med, 2017, 166(3): 191-200. DOI: 10.7326/M16-1901. [37] WEN YK. Impact of acute kidney injury on metformin-associated lactic acidosis[J]. Int Urol Nephrol, 2009, 41(4): 967-972. DOI: 10.1007/s11255-009-9549-6. [38] CAI Z, WU X, SONG Z, et al. Metformin potentiates nephrotoxicity by promoting NETosis in response to renal ferroptosis[J]. Cell Discov, 2023, 9(1): 104. DOI: 10.1038/s41421-023-00595-3. [39] LEE MC, LEE CH, CHANG LY, et al. Association of metformin use with end-stage renal disease in patients with type 2 diabetes mellitus: a nationwide cohort study under the pay-for-performance program[J]. J Clin Pharmacol, 2019, 59(11): 1443-1452. DOI: 10.1002/jcph.1452. [40] KHARAZMKIA A, AHMADPOOR P, ZIAEI S, et al. Effects of pioglitazone on blood glucose and inflammatory markers of diabetic kidney transplant patients: a randomized controlled trial[J]. Iran J Kidney Dis, 2014, 8(5): 408-416. [41] ARASHNIA R, ROOHI-GILANI K, KARIMI-SARI H, et al. Effect of pioglitazone therapy on high sensitive C-reactive protein and lipid profile in diabetic patients with renal transplantation; a randomize clinical trial[J]. J Nephropathol, 2015, 4(2): 48-53. DOI: 10.12860/ jnp.2015.10. DOI: 10.12860/jnp.2015.10. [42] 闫赋琴, 徐春, 程海梅, 等. 瑞格列奈治疗肾移植后糖尿病的疗效和安全性[J]. 武警医学, 2016, 27(5): 449-451. DOI: 10.3969/j.issn.1004-3594.2016.05.006.YAN FQ, XU C, CHENG HM, et al. A clinical study on repaglinide therapy of diabetes mellitus after renal transplantation[J]. Med J Chine People's Armed Police Forces, 2016, 27(5): 449-451. DOI: 10.3969/j.issn.1004-3594.2016.05.006. [43] NIU YJ, SHEN ZY, XU C, et al. Establishment of tacrolimus-induced diabetes in rat model and assessment of clinical treatments for post-transplant diabetes mellitus in liver transplant recipients[J]. Clin Lab, 2013, 59(7/8): 869-874. DOI: 10.7754/clin.lab.2012.120913. [44] 非磺脲类胰岛素促泌剂瑞格列奈临床应用共识[J]. 中国全科医学, 2010, 13(16): 1804.Consensus on the clinical application of non sulfonylurea insulin secretagogue regagliptin[J].Chin Gen Pract, 2010,13(16): 1804 . [45] KAJOSAARI LI, NIEMI M, NEUVONEN M, et al. Cyclosporine markedly raises the plasma concentrations of repaglinide[J]. Clin Pharmacol Ther, 2005, 78(4): 388-399. DOI: 10.1016/j.clpt.2005.07.005. [46] LANE JT, ODEGAARD DE, HAIRE CE, et al. Sitagliptin therapy in kidney transplant recipients with new-onset diabetes after transplantation[J]. Transplantation, 2011, 92(10): e56-e57. DOI: 10.1097/TP.0b013e3182347ea4. [47] BOERNER BP, MILES CD, SHIVASWAMY V. Efficacy and safety of sitagliptin for the treatment of new-onset diabetes after renal transplantation[J]. Int J Endocrinol, 2014: 617638. DOI: 10.1155/2014/617638. [48] STRØM HALDEN TA, ÅSBERG A, VIK K, et al. Short-term efficacy and safety of sitagliptin treatment in long-term stable renal recipients with new-onset diabetes after transplantation[J]. Nephrol Dial Transplant, 2014, 29(4): 926-933. DOI: 10.1093/ndt/gft536. [49] SOLIMAN AR, FATHY A, KHASHAB S, et al. Sitagliptin might be a favorable antiobesity drug for new onset diabetes after a renal transplant[J]. Exp Clin Transplant, 2013, 11(6): 494-498. DOI: 10.6002/ect.2013.0018. [50] HAIDINGER M, WERZOWA J, HECKING M, et al. Efficacy and safety of vildagliptin in new-onset diabetes after kidney transplantation--a randomized, double-blind, placebo-controlled trial[J]. Am J Transplant, 2014, 14(1): 115-123. DOI: 10.1111/ajt.12518. [51] SANYAL D, GUPTA S, DAS P. A retrospective study evaluating efficacy and safety of linagliptin in treatment of NODAT (in renal transplant recipients) in a real world setting[J]. Indian J Endocrinol Metab, 2013, 17(Suppl 1): S203-S205. DOI: 10.4103/2230-8210.119572. [52] ATTALLAH N, YASSINE L. Linagliptin in the management of type 2 diabetes mellitus after kidney transplant[J]. Transplant Proc, 2021, 53(7): 2234-2237. DOI: 10.1016/j.transproceed.2021.07.035. [53] ABDELAZIZ TS, ALI AY, FATTHY M. Efficacy and safety of dipeptidyl peptidase-4 inhibitors in kidney transplant recipients with post-transplant diabetes mellitus (PTDM)-a systematic review and meta-analysis[J]. Curr Diabetes Rev, 2020, 16(6): 580-585. DOI: 10.2174/1573399815666190321144310. [54] BERGMAN AJ, COTE J, YI B, et al. Effect of renal insufficiency on the pharmacokinetics of sitagliptin, a dipeptidyl peptidase-4 inhibitor[J]. Diabetes Care, 2007, 30(7): 1862-1864. DOI: 10.2337/dc06-2545. [55] HE YL, SABO R, CAMPESTRINI J, et al. The influence of hepatic impairment on the pharmacokinetics of the dipeptidyl peptidase Ⅳ (DPP-4) inhibitor vildagliptin[J]. Eur J Clin Pharmacol, 2007, 63(7): 677-686. DOI: 10.1007/s00228-007-0312-6. [56] BAE J, LEE MJ, CHOE EY, et al. Effects of dipeptidyl peptidase-4 inhibitors on hyperglycemia and blood cyclosporine levels in renal transplant patients with diabetes: a pilot study[J]. Endocrinol Metab (Seoul), 2016, 31(1): 161-167. DOI: 10.3803/EnM.2016.31.1.161. [57] CHEWCHARAT A, PRASITLUMKUM N, THONGPRAYOON C, et al. Efficacy and safety of SGLT-2 inhibitors for treatment of diabetes mellitus among kidney transplant patients: a systematic review and meta-analysis[J]. Med Sci (Basel), 2020, 8(4): 47. DOI: 10.3390/medsci8040047. [58] OIKONOMAKI D, DOUNOUSI E, DUNI A, et al. Incretin based therapies and SGLT-2 inhibitors in kidney transplant recipients with diabetes: a systematic review and meta-analysis[J]. Diabetes Res Clin Pract, 2021, 172: 108604. DOI: 10.1016/j.diabres.2020.108604. [59] HALDEN T, KVITNE KE, MIDTVEDT K, et al. Efficacy and safety of empagliflozin in renal transplant recipients with posttransplant diabetes mellitus[J]. Diabetes Care, 2019, 42(6): 1067-1074. DOI: 10.2337/dc19-0093. [60] LIM JH, KWON S, JEON Y, et al. The efficacy and safety of SGLT2 inhibitor in diabetic kidney transplant recipients[J]. Transplantation, 2022, 106(9): e404-e412. DOI: 10.1097/TP.0000000000004228. [61] SÁNCHEZ FRUCTUOSO AI, BEDIA RABA A, BANEGAS DERAS E, et al. Sodium-glucose cotransporter-2 inhibitor therapy in kidney transplant patients with type 2 or post-transplant diabetes: an observational multicentre study[J]. Clin Kidney J, 2023, 16(6): 1022-1034. DOI: 10.1093/ckj/sfad007. [62] HISADOME Y, MEI T, NOGUCHI H, et al. Safety and efficacy of sodium-glucose cotransporter 2 inhibitors in kidney transplant recipients with pretransplant type 2 diabetes mellitus: a retrospective, single-center, inverse probability of treatment weighting analysis of 85 transplant patients[J]. Transplant Direct, 2021, 7(11): e772. DOI: 10.1097/TXD.0000000000001228. [63] CEHIC MG, MUIR CA, GREENFIELD JR, et al. Efficacy and safety of empagliflozin in the management of diabetes mellitus in heart transplant recipients[J]. Transplant Direct, 2019, 5(5): e450. DOI: 10.1097/TXD.0000000000000885. [64] SAMMOUR Y, NASSIF M, MAGWIRE M, et al. Effects of GLP-1 receptor agonists and SGLT-2 inhibitors in heart transplant patients with type 2 diabetes: initial report from a cardiometabolic center of excellence[J]. J Heart Lung Transplant, 2021, 40(6): 426-429. DOI: 10.1016/j.healun.2021.02.012. [65] CHA BM, DAVOUDI R, DIVITA MC, et al. Sodium-glucose cotransporter-2 inhibitor-associated euglycemic diabetic ketoacidosis after orthotopic heart transplant in a prediabetic patient: a case report[J]. Transplant Proc, 2021, 53(8): 2636-2639. DOI: 10.1016/j.transproceed.2021.08.017. [66] SWEISS H, SELZNICK L, CONTRERAS J, et al. Safety and efficacy of sodium-glucose cotransporter-2 inhibitors in solid organ transplant recipients[J]. Prog Transplant, 2023, 33(3): 261-265. DOI: 10.1177/15269248231189880. [67] HALDEN TA, EGELAND EJ, ÅSBERG A, et al. GLP-1 restores altered insulin and glucagon secretion in posttransplantation diabetes[J]. Diabetes Care, 2016, 39(4): 617-624. DOI: 10.2337/dc15-2383. [68] SINGH P, TAUFEEQ M, PESAVENTO TE, et al. Comparison of the glucagon-like-peptide-1 receptor agonists dulaglutide and liraglutide for the management of diabetes in solid organ transplant: a retrospective study[J]. Diabetes Obes Metab, 2020, 22(5): 879-884. DOI: 10.1111/dom.13964. [69] KIM HS, LEE J, JUNG CH, et al. Dulaglutide as an effective replacement for prandial insulin in kidney transplant recipients with type 2 diabetes mellitus: a retrospective review[J]. Diabetes Metab J, 2021, 45(6): 948-953. DOI: 10.4093/dmj.2020.0180. [70] THANGAVELU T, LYDEN E, SHIVASWAMY V. A retrospective study of glucagon-like peptide 1 receptor agonists for the management of diabetes after transplantation[J]. Diabetes Ther, 2020, 11(4): 987-994. DOI: 10.1007/s13300-020-00786-1. [71] SINGH P, PESAVENTO TE, WASHBURN K, et al. Largest single-centre experience of dulaglutide for management of diabetes mellitus in solid organ transplant recipients[J]. Diabetes Obes Metab, 2019, 21(4): 1061-1065. DOI: 10.1111/dom.13619. [72] SWEISS H, HALL R, ZEILMANN D, et al. Single-center evaluation of safety & efficacy of glucagon-like peptide-1 receptor agonists in solid organ transplantation[J]. Prog Transplant, 2022, 32(4): 357-362. DOI: 10.1177/15269248221122867. [73] KUKLA A, HILL J, MERZKANI M, et al. The use of GLP1R agonists for the treatment of type 2 siabetes in kidney transplant recipients[J]. Transplant Direct, 2020, 6(2): e524. DOI: 10.1097/TXD.0000000000000971. [74] YUGUEROS GONZÁLEZ A, KANTER J, SANCHO A, et al. Institutional experience with new antidiabetic drugs in kidney transplant[J]. Transplant Proc, 2021, 53(9): 2678-2680. DOI: 10.1016/j.transproceed.2021.08.042. [75] SATO T, AZUMA Y, OZONE C, et al. Possible advantage of glucagon-like peptide 1 receptor agonists for kidney transplant recipients with type 2 diabetes[J]. J Clin Endocrinol Metab, 2023, 108(10): 2597-2603. DOI: 10.1210/clinem/dgad177. [76] SOLIMAN AR, SOLIMAN H, AHMED RM. Effect of insulin degludec versus insulin glargine on glycemic variability in patients with renal transplantation with pre-existing type 2 diabetes mellitus; a 1-year, randomized, treat-to-target pilot trial[J]. Iran J Kidney Dis, 2021, 15(5): 385-390. [77] 冉兴无, 母义明, 朱大龙, 等. 成人2 型糖尿病基础胰岛素临床应用中国专家指导建议(2020 版)[J]. 中国糖尿病杂志, 2020, 28(10): 721-728. DOI: 10.3969/j.issn.1006-6187.2020.10.001.RAN XW, MU YM, ZHU DL, et al. Chinese expert recommendations on basal insulin treatment in adult type 2 diabetes mellitus[J]. Chin J Diabetes, 2020, 28(10): 721-728. DOI: 10.3969/j.issn.1006-6187.2020.10.001. [78] 中华医学会内分泌学分会. 预混胰岛素临床应用专家共识(2016 年版)[J]. 药品评价, 2016, 13(9): 5-11. DOI: 10.3969/j.issn.1672-2809.2016.09.002.Chinese Society of Endocrinology. Chinese experts consensus statement on premixed insulin in the clinical practice[J]. Drug Eval, 2016, 13(9): 5-11. DOI: 10.3969/j.issn.1672-2809.2016.09.002. [79] 朱大龙, 赵维纲, 匡洪宇, 等. 德谷门冬双胰岛素临床应用专家指导意见[J]. 中华糖尿病杂志, 2021, 13(7): 695-701. DOI: 10.3760/cma.j.cn115791-20210506-00247.ZHU DL, ZHAO WG, KUANG HY, et al. Expert consensus on clinical application of insulin degludec/insulin aspart[J]. Chin J Diabetes, 2021, 13(7): 695-701. DOI: 10.3760/cma.j.cn115791-20210506-00247. [80] 母义明, 朱大龙, 李焱, 等. 速效胰岛素类似物临床应用专家指导意见[J]. 药品评价, 2016, 13(21): 13-17,53. DOI: 10.3969/j.issn.1672-2809.2016.21.002.MU YM, ZHU DL, LI Y, et al. Experts opinion of rapid-acting insulin analogs on clinical applications[J]. Drug Eval, 2016, 13(21): 13-17,53. DOI: 10.3969/j.issn.1672-2809.2016.21.002. -
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