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Published on: June 11, 2020
Continuous Glucose Monitoring Before and After Simultaneous Pancreas-Kidney Transplantation: Insights from a
Antonio J Amor1,2,3,4, Clara Solà5, Pedro Ventura-Aguiar6,7,8
1Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic Barcelona, Villarroel 170, 08036, Barcelona, Spain. ajamor@clinic.cat.
Introduction:
Simultaneous pancreas-kidney (SPK) transplantation normalizes glycemia in patients with diabetes and end-stage kidney disease, yet data on continuous glucose monitoring (CGM) remain scarce.
Methods:
We retrospectively analyzed CGM metrics in SPK recipients using FreeStyle Libre 2®, comparing pre- and post-transplant profiles.
Results:
Among n = 19 recipients, only n = 14 continued CGM use after transplantation (n = 9 continuously during the entire study period). Within 1 month, all CGM metrics improved significantly, including increased time-in-range (54.21 vs. 83.85%) and time-in-tight-range (TITR; 33.45 vs. 69.77%), and reduced glucose variability (p < 0.05 for all comparisons), with stability over 24 months. Optimal graft function was associated with superior CGM outcomes, notably higher TITR and lower mean amplitude of glycemic excursions (MAGE; p < 0.05). However, hypoglycemia-related targets were not consistently achieved despite otherwise optimal graft performance.
Conclusions:
SPK transplantation was linked to rapid and sustained improvement in CGM profiles. These findings underscore CGM's value for monitoring graft function and support its integration into post-transplant care to optimize metabolic outcomes.
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