Nutritional status and de-novo diabetes in untrained renal transplant patients

Introduction and Aims: Although exercise capacity improves after renal transplantation, it often remains subnormal. Physical activity optimizes physical functioning following transplant and it may reduce or attenuate side effects of immunosuppression. One of these side effects is Diabetes Mellitus that may arise in transplanted patients. Aim of the study: Finding association among physical activity, nutritional status and post transplant Diabetes Mellitus (PTDM) Methods: We performed a study on renal transplant patients in order to evaluate the effects of physical activity on nutritional status. Then we observed the occurrence of PTDM in trained and untrained patients. 73 patients with renal transplant were enrolled. Mean age was 53.33 (range 20-77 years), 62.5% male, BMI was within the range of normal in 51.72% of cases, in 3.45% was <19, and 44.83% of cases were in the range of overweight or obesity (over 26). All patients were administered a questionnaire on physical activity. The questionnaire included 4 questions about the degree of intensity of exercise in the last 6 months. Results: From the questionnaire scores, it was possible to identify three groups of patients, performing mild (4 to 7 points), moderate (8-11 points) or strong (> 12 points) physical activity. The results showed that more than 50% of patients practice exercise from mild to moderate intensity. The correlation between total score of physical activity and BMI evidenced that moderate and intense physical activity is mainly performed by patients with normal BMI. Moderate activity score was significantly associated with a better nutritional status (p<0,01). Mild activity score was significantly associated with a higher incidence of DM post-tx (p<0.02) Conclusions: Exercise initiated early after transplantation may lead to important results for restoring muscle function, avoiding weight gain due to sedentary life-style and improving nutritional status. Moreover, regular physical activity may reduce or attenuate side effects of immunosuppression, like new occurrence of diabetes.