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The acronym NODAT stands for “new onset diabetes after transplant”. Diabetes is one of the many complications which occur in the post-renal transplant setting. The reasons for this are manifold. Transplant recipients who require long-term steroids will obviously have an increased susceptibility to diabetes and metabolic syndrome. In addition, cyclosporine inhibitors–tacrolimus moreso than cyclosporine–appear to have some direct beta-cell toxicity, as well as predisposing to hypertension and hyperlipidemia which often go hand-in-hand with the diabetic phenotype. Finally, improved renal function leads to increased insulin clearance by the kidney, and previously diabetic individuals who were previously insulin-independent may require exogenous supplementation in order to meet their insulin needs.

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