OBJECTIVE: A systematic review of the prevalence and prognosis of posttransplant diabetes mellitus (PTDM) following transplantation of heart, lung, liver and kidney and a meta-analysis of randomised studies of glucose-lowering treatment is reported.

METHODS: We searched for publications on solid organs transplantation and PTDM in relation to risk and total mortality of PTDM and randomized controlled trials aiming at reducing glucose levels.

RESULTS: PTDM prevalence one year after transplantation was reported to 9-40 %. Ten years after transplantation, 60-85% of people without PTDM and 30-76% of people with PTDM were alive. We identified six randomized controlled trials on the treatment of PTDM, all following kidney transplantation. Intervention ranged from 3 to 12 months. Four studies used intervention with oral glucose-lowering drugs, one used dietician appointment and exercise, and one used insulin treatment. Among the intermediate results reported, a reduction in HbA1c of 2.7 mmol/mol, and an increase in the odds ratio of serious adverse events of 3.0 was significant.

CONCLUSION: In conclusion, information on the prevalence and effect on survival of PTDM is heterogeneous, and the randomized studies on the effect of treatment available are either short and/or lack information on clinically important endpoints, as mortality or morbidity.