Continuous glucose monitoring to assess glycemic control in the first 6 weeks after pancreas transplantation

Vikash Dadlani, Ravinder Jeet Kaur, Mark Stegall, Souzana Eirini Xyda, Kanchan Kumari, Keisha Bonner, Byron Smith, Prabin Thapa, Patrick G. Dean, Yogish C. Kudva

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article numbere13719
JournalClinical Transplantation
Volume33
Issue number10
DOIs
StatePublished - Oct 1 2019

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Pancreas Transplantation
Glucose
Pancreas
Type 1 Diabetes Mellitus
Kidney
Kidney Transplantation
Chronic Kidney Failure

Keywords

  • continuous glucose monitor
  • glycemic variability
  • hyperglycemia and hypoglycemia
  • pancreas transplantation
  • Type 1 diabetes

ASJC Scopus subject areas

  • Transplantation

Cite this

Continuous glucose monitoring to assess glycemic control in the first 6 weeks after pancreas transplantation. / Dadlani, Vikash; Kaur, Ravinder Jeet; Stegall, Mark; Xyda, Souzana Eirini; Kumari, Kanchan; Bonner, Keisha; Smith, Byron; Thapa, Prabin; Dean, Patrick G.; Kudva, Yogish C.

In: Clinical Transplantation, Vol. 33, No. 10, e13719, 01.10.2019.

Research output: Contribution to journalArticle

Dadlani, Vikash ; Kaur, Ravinder Jeet ; Stegall, Mark ; Xyda, Souzana Eirini ; Kumari, Kanchan ; Bonner, Keisha ; Smith, Byron ; Thapa, Prabin ; Dean, Patrick G. ; Kudva, Yogish C. / Continuous glucose monitoring to assess glycemic control in the first 6 weeks after pancreas transplantation. In: Clinical Transplantation. 2019 ; Vol. 33, No. 10.
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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.

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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.

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