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 - Funding Information:
Funding information This work was supported by the Pirnie Research Award of the Mayo Foundation. We thank patients and their families, post-transplant coordinators and RN Certified Diabetes Educators at our institution.
Funding Information:
YCK is a currently a co‐investigator on NIH funded Artificial Pancreas (AP) studies, has received funding for AP research from JDRF and Helmsley Charitable Trust, has conducted AP research sponsored by Medtronic, and has received research support/product support to his institution from Tandem Diabetes, Roche Diabetes and Dexcom Inc All other authors have nothing to disclose.
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 -