TY - JOUR
T1 - Continuous glucose monitoring to assess glycemic control in the first 6 weeks after pancreas transplantation
AU - Dadlani, Vikash
AU - Kaur, Ravinder Jeet
AU - Stegall, Mark
AU - Xyda, Souzana Eirini
AU - Kumari, Kanchan
AU - Bonner, Keisha
AU - Smith, Byron
AU - Thapa, Prabin
AU - Dean, Patrick G.
AU - Kudva, Yogish C.
N1 - Publisher Copyright:
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2019/10/1
Y1 - 2019/10/1
N2 - 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.
AB - 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.
KW - Type 1 diabetes
KW - continuous glucose monitor
KW - glycemic variability
KW - hyperglycemia and hypoglycemia
KW - pancreas transplantation
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U2 - 10.1111/ctr.13719
DO - 10.1111/ctr.13719
M3 - Article
C2 - 31545535
AN - SCOPUS:85074021382
SN - 0902-0063
VL - 33
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 10
M1 - e13719
ER -