Background: Diabetes mellitus occurs in a substantial number of patients following renal transplantation. The presence of Insulin resistance in diabetics can be assessed by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Homeostasis Model Assessment Beta cell dysfunction (HOMA-B). The optimal cutoffs for HOMA-IR and HOMA-B and the diagnostic performance of predictors for Posttransplant Diabetes Mellitus (PTDM) in the Indian population are not precisely known. Objectives: Our study was aimed at determining the optimal cutoffs for HOMA-IR and HOMA-B in renal transplant recipients who developed PTDM, as well as to determine the diagnostic performance of the parameters for prediction in kidney transplant recipients who develop PTDM. Materials and Methods: The HOMA 2 calculator was used to determine HOMA-IR and HOMA-B in 58 living related donor renal transplant recipients who underwent transplantation in our center and followed up for a mean period of 12 months (range: 6–24 months) after transplantation. Results: For HOMA-IR, a cut-off value of 1.76 and for HOMA-B, 73.5% were obtained, indicating that values above this level significantly increase the risk of PTDM. Cumulative Prednisolone dose at 3 months after transplant, HOMA-B posttransplant, total calorie intake posttransplant, HOMA-IR posttransplant, body mass index posttransplant, and serum fasting Insulin levels were identified as significant predictors of PTDM. Conclusion: The identified cutoffs and diagnostic parameters can be used as early risk assessment tools for the development of PTDM in renal transplant recipients.
Kumar et al. (Thu,) studied this question.