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Continuous glucose monitoring to assess glycemic control in the first 6 weeks after pancreas transplantation
Author(s) -
Dadlani Vikash,
Kaur Ravinder Jeet,
Stegall Mark,
Xyda SouzanaEirini,
Kumari Kanchan,
Bonner Keisha,
Smith Byron,
Thapa Prabin,
Dean Patrick G.,
Kudva Yogish C.
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13719
Subject(s) - medicine , glycemic , transplantation , pancreas transplantation , urology , pancreas , kidney transplantation , type 1 diabetes , diabetes mellitus , cohort , continuous glucose monitoring , gastroenterology , kidney disease , surgery , endocrinology
Background Current therapy for Type 1 diabetes (T1D) is characterized by significant glucose variability (GV). Pancreas transplantation (PT) is performed in certain T1D patients with and without end‐stage renal disease. To date, GV has been examined to a limited extent after PT. Methods We investigated GV using continuous glucose monitoring (CGM) 3‐6 weeks after PT. Results Eleven patients had simultaneous kidney pancreas transplantation (SPK), nine pancreas after kidney (PAK), and six pancreas transplantation alone (PTA). Mean CGM showed no difference between SPK, 126.5 ± 13.9, PAK 119.9 ± 12.8, and PTA 131.1 ± 29 mg/dL ( P value .6). Percentage of time in range (TIR, 70‐180 mg/dL) was 92% for SPK, 93.4% in PAK, and 88.5% in PTA with only 0.3%, 1.5%, and 0.3% of time <70 mg/dL. Percentage >180 mg/dL was 7.9% for SPK, 4.9% PAK, and 11% in PTA. Other measures of GV were similar in the three cohorts. In six patients, CGM was performed before and after PT and improved significantly. GV was also better compared with a matched cohort of T1D patients. Conclusions All 3 types of PT resulted in excellent glucose control 3‐6 weeks post‐procedure. CGM outcomes represent an important objective outcome after PT.