Diabetes Mellitus in HSCT

Diabetes mellitusDiabetes Mellitus (DM) is a chronic metabolic condition characterized byhyperglycemiaHyperglycemia resulting from defects in insulin production or function. Hematopoietic stem cell transplantationHematopoietic Stem Cell Transplantation (HSCT) (HSCT) can impact glycemic control and diabetes risk both positively and negatively. This chapter discusses the relationship between DM and HSCT. HSCT recipients are at high risk of hyperglycemia and developing post-transplant diabetes mellitusPost-Transplant Diabetes Mellitus (PTDM). HyperglycemiaHyperglycemia is linked to worse transplant outcomes including increased infection risk, graft-versus-host diseaseGraft Versus Host Disease (GVHD) (GVHD), hospital length of stay, and mortality. The development of PTDM is multifactorial, influenced by patient characteristics, immunosuppressive medications like corticosteroids, and GVHD. Screening and tight glycemic control are important for optimizing outcomes after HSCTHematopoietic Stem Cell Transplantation (HSCT). HSCT represents a promising treatment approach for certain types of diabetes. For type 1 diabetes mellitus (T1DM), HSCT aims to induce immune tolerance and regeneration of pancreatic beta cells through immunomodulation and myeloablation. Several clinical trials demonstrate HSCT can achieve insulin independence in T1DM patients for years with an acceptable safety profile. However, larger and longer-term studies are still needed. The potential mechanisms by which HSCTHematopoietic Stem Cell Transplantation (HSCT) may treat type 2 diabetes mellitus (T2DM) include immune reset, beta cell regeneration, and anti-inflammatory effects, but efficacy data specifically for HSCT in T2DM is still limited. In conclusion, DM profoundly impacts HSCT outcomes and remains an important consideration in long-term survivorship care. Further, HSCT shows potential as a curative approach for some forms of diabetes but requires additional research to optimize outcomes and safety.