title: Early postoperative continuous glucose monitoring in pancreas transplant recipients.
abstract: Continuous glucose monitoring (CGM) is used in people with type 1 diabetes to help with insulin treatment regimens. Its value in whole-organ pancreas transplantation (PT) is largely unknown. This study aimed to use CGM to assess the metabolic profile of pancreas transplant recipients in the early post-transplant period. We studied CGM data in 30 PT recipients and related findings to an early oral glucose tolerance test (OGTT). Complete data were available for 26 recipients. Seven days after a PT, normoglycaemia was present 77.9% of the time. Hypoglycaemic events (glucose <3.9 mmol/l) occurred in 10 of 26 (38.5%) of the cohort, but were infrequent (present 1.4% of the time). Hyperglycaemia (glucose >7.8 mmol/l) was present for 20.7% of the study period and correlated with a diagnosis of abnormal glucose tolerance. Whilst normoglycaemia is successfully achieved for the majority of the time after PT, hypoglycaemia can occur. Hyperglycaemia is more common and correlates well with the early postoperative OGTT, which is associated with graft failure. CGM is easier to perform and provides 24-h data that could inform clinical decision-making in patients in the postoperative period.
authors.affiliation: Oxford Transplant Centre, Oxford University Hospital NHS Trust, Oxford, UK; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
authors.forename: Shruti
authors.initials: S
authors.lastname: Mittal
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Franklin
authors.forename: Caterina
authors.initials: C
authors.lastname: Policola
authors.forename: Edward
authors.initials: E
authors.lastname: Sharples
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Friend
authors.forename: Stephen C L
authors.initials: SC
authors.lastname: Gough
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007003:Hypoglycemia / Q000097:blood; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010179:Pancreas / Q000601:surgery; D016035:Pancreas Transplantation; D011184:Postoperative Period; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: glucose; hyperglycaemia; monitoring; pancreas transplantation