*Purpose: New-onset of diabetes mellitus after transplantation (NODAT) is a serious and common complication following solid organ transplantation. Our study aims to examine the risk factors for NODAT and evaluate early graft function via pre-transplant oral glucose tolerance test (OGTT) and post-transplant blood glucose state.

*Methods: Our study retrospectively reviewed 1317 recipients who received single-organ kidney transplant at the first Affiliated Hospital of Zhejiang University between January 2015 and June 2018. Diagnosis of NODAT was defined according to the American Diabetes Association criteria. OGTT was performed before transplantation in 1221 of these recipients.

*Results: NODAT was diagnosed in 161 (12.2 %) patients within 1 year. Deceased donor (odds ratio [OR], 3.14; 95 % Confidence interval [CI]: 2.10-4.71), body mass index (BMI) >or=24 (OR, 1.90; 95 % CI: 1.30-2.77), age >or=45 years (OR, 3.06; 95 % CI: 2.19-4.29), pre-transplant serum glucose level (β, 1.34; 95 % CI: 1.09-1.64), pre-transplant impaired glucose regulation (OR, 2.71; 95 % CI: 1.90-3.85) and acute rejection (OR, 2.61; 95 % CI: 1.61-4.25) were independent risk factors for NODAT by multivariate analysis. And high number of HLA matches was for NODAT in living donor kidney transplantation. Smoking and alcohol consumption were also associated with increased risk of NODAT. For deceased cardiac donor kidney transplant recipients, estimated glomerular filtration rate (eGFR-MDRD) was no significantly different between NODAT group and no-NODAT group within the first month follow-up (p = 0.163,0.968,0.059 for the 7th days, 14th days, 1st month, respectively). When follow-up period were more than 3 months, eGFR-MDRD was significantly higher in no-NODAT group than NODAT group (p=0.018, 0.012, 0.022 for the 3rd month, 6th month, 12th month, respectively). Similar results were obtained in living donor kidney transplant recipients. According to pre-transplant OGTT, recipients were divided into 3 groups: normal glucose tolerance (NGT), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). No significant difference in post-transplant EGFR-MDRD within first year follow-up was obtained among these groups.

*Conclusions: Our results show that deceased donor, high BMI, old age, pre-transplant serum glucose level, pre-transplant impaired glucose regulation and acute rejection are independent risk factors association with NODAT,which may be helpful for identifying patients at risk for NODAT. With increasing length of follow-up, there is a changing influence of NODAT on early graft function, but further analysis with a longer follow-up is necessary.

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