Continuous Glucose Monitoring for Pancreatogenic Diabetes After Total Pancreatectomy

Continuous glucose monitoring (CGM) is increasingly used for glycemic control, but its role after total pancreatectomy (TP) in pancreatogenic diabetes mellitus (PDM) is understudied. This study evaluated postoperative CGM utility in this population.

Thirty-seven TP patients (2022-2024) at Seoul National University Hospital were grouped by CGM use (CGM users = 11) and analyzed for baseline and perioperative diabetes-related factors. In a preoperative non-diabetic subgroup (n = 10, CGM users = 6), pre- and postoperative hemoglobin A1c (HbA1c) was compared by CGM use. For consenting CGM users, changes in time in range (TIR), time above range (TAR), and time below range (TBR) from 1 to 3 months postoperatively were analyzed.

CGM users had lower postoperative HbA1c than non-users overall (6.5% vs. 8.0%; p < 0.001) and in non-diabetics (6.0% vs. 7.4%; p = 0.002). Among 80% sharing CGM data, TIR increased from 62.6% at 1 month to 71.8% at 3 months (p = 0.035), TAR decreased from 36.3% to 26.6% (p = 0.037), and TBR was unchanged.

Proactive CGM use may improve postoperative glycemic management in PDM after TP by increasing awareness of glycemic patterns, resulting in lower HbA1c and greater time in the target range.