Construction and Validation of a Bundle for Screening and Diagnosis of Posttransplant Diabetes Mellitus in Kidney Transplant Recipients

Introduction: Posttransplant diabetes mellitus (PTDM) is a potential consequence of kidney transplantation (KTx), and its prompt identification has a beneficial effect on patient longevity and graft maintenance. Although the diagnostic standards for PTDM remain identical to those used for the general public, the reliability of the assessments differs in KTx patients, and their recognition is often overlooked when fasting glucose (FG) is utilized as the sole screening method. Objectives: We intended to design and authenticate a care bundle for the screening and identification of PTDM in KTx individuals. Methods: The following procedures were carried out: a) literature survey; b) development of the bundle; and c) expert validation by qualified reviewers. The integrative review served as a resource in formulating the bundle. We assessed the experts’ feedback using the content validity index (CVI). A binomial analysis was executed to determine the consensus among the reviewers. Results: The bundle was organized to deliver guidance regarding: 1) which examination(s) to order; 2) the optimal timing to request them to distinguish PTDM from temporary hyperglycemia; and 3) which individuals require further assessments beyond FG. Every component was deemed validated, with an overall CVI of 0.99. Conclusion: The bundle was judged reliable for supporting clinical judgment in conducting PTDM screening and diagnosis in KTx individuals in a straightforward and efficient manner. We propose integrating this instrument into clinical routines due to its ease of use, affordability, and potential to enhance the care of these patients.