title: Continuous glucose monitoring system (CGMS) in kidney-transplanted children.
abstract: NODAT and IGT are well-known complications of immunosuppressive therapy after transplantation being a risk factor for cardiovascular disease affecting patient and graft survival. Therefore, early identification and treatment are of high importance. In this study, we examined the glycemic homeostasis of 20 renal-transplanted children using routine laboratory tests and the continuous glucose monitoring system (CGMS). Six patients (30%) had IGT, and one patient had NODAT (5%). The HOMA index was in an abnormal range in 35% of all patients and was abnormal in 67% of the IGT patients. CGMS analysis showed that IGT patients had higher "lowest glucose" level, and the incidence of hypoglycemic episodes was significantly lower compared with patients with normal OGTT result. In IGT patients, glucose variability tended to be lower. Furthermore, in the whole patient cohort, glucose variability significantly decreased with time after transplantation. Summarizing, these novel data show that "lowest glucose" level and hypoglycemic episodes are significantly influenced and altered in renal-transplanted patients with IGT. Furthermore, there is a decrease in glucose variability with time after transplantation. The mechanism and relevance of these data need further investigations.
authors.affiliation: First Department of Pediatrics and Nephrology, Research Laboratory of the Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Pasti
authors.forename: Attila J
authors.initials: AJ
authors.lastname: Szabo
authors.forename: Agnes
authors.initials: A
authors.lastname: Prokai
authors.forename: Krisztina
authors.initials: K
authors.lastname: Meszaros
authors.forename: Nora
authors.initials: N
authors.lastname: Peko
authors.forename: Reka
authors.initials: R
authors.lastname: Solyom
authors.forename: Peter
authors.initials: P
authors.lastname: Sallay
authors.forename: György
authors.initials: G
authors.lastname: Reusz
authors.forename: Krisztina
authors.initials: K
authors.lastname: Rusai
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005260:Female; D018149:Glucose Intolerance / Q000150:complications; D005951:Glucose Tolerance Test / Q000379:methods*; D006085:Graft Survival; D006706:Homeostasis; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000150:complications; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D051437:Renal Insufficiency / Q000150:complications* / Q000628:therapy; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: continous glucose monitoring; glycemic control; renal transplantation