Continuous Glucose Monitoring in Subjects After Simultaneous Pancreas-Kidney and Kidney-Alone Transplantation

Abstract

Background: Simultaneous pancreas-kidney (SPK) transplantation is an important replacement therapy for individuals with diabetes and end-stage renal disease. Kidney-alone (KA) transplantation is associated with a high incidence of post-transplant diabetes.Methods: This was a cross-sectional study. We studied 48-h glucose concentrations in eight subjects with type 1 diabetes mellitus after SPK transplantation, six subjects post-KA transplantation, and nine healthy controls using the CGMS Ò (Medtronic Minimed, Northridge, CA) continuous glucose monitoring system. Results: The 48-h mean glucose concentration was 101 AE 7 mg=dL in the SPK subjects, 105 AE 12 mg=dL in the KA subjects, and 99 AE 7 mg=dL in the healthy controls. The glycemic excursions were higher in the KA group compared to the SPK cohort and healthy controls (P < 0.0001). No differences in the incidence of hypoglycemia were detected among the three groups. Significant postprandial hyperglycemia was uncovered in four of the six KA subjects. Conclusions: SPK transplantation is very effective at normalizing glycemic excursions. Unsuspected hyperglycemia was identified in the KA group. The CGMS was a useful ambulatory tool to study glucose profiles in the post-transplant period and may help uncover hyperglycemia undetected by routine laboratory testing.

Nocturnal Hypoglycemia Identified by a Continuous Glucose Monitoring System in Patients with Primary Adrenal Insufficiency (Addison's Disease)

“…12 So, data of this small study do not allow us to conclude about glucose metabolism in adrenal-insufficient patients who are receiving chronic replacement-either for hypoglycemia episodes due to chronic cortisol deficiency or for hyperglycemia episodes due to chronic overtreatment.…”

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