Continuous Glucose Monitoring for Postkidney Transplantation in Patient With Pre-existing Type 2 Diabetes

Kidney transplantation poses glycemic control challenges for type 2 diabetes mellitus due to immunosuppressive therapy and metabolic changes. In this pilot study, we aimed to assess glucometrics achieved with a continuous glucose monitor (CGM)-based insulin titration protocol during prednisone taper postkidney transplant.

Kidney transplant recipients with pre-existing type 2 diabetes mellitus on insulin therapy were enrolled. CGM metrics were used to adjust insulin dose for 3 months. Data up to 6 months were included. CGM metrics, insulin and prednisone doses, kidney function, and clinical outcomes were analyzed.

Time in range increased from 44.2% to 60.8% at 3 months (P = .005) and 72.9% at 6 months (P < .001). TBR 54-69 mg/dL was 0.3% baseline, 0.4% at 3 months (P = .11) and 0.6% at 6 months (P = .036), whereas TBR <54 mg/dL was 0% at baseline with no significant increase at 3 and 6 months. Average glucose decreased from 194.7 mg/dL to 160.6 mg/dL at 3 months and 148.0 mg/dL at 6 months (P < .001). The estimated mean total insulin dose per kg body weight was 0.48 units/kg at baseline, 0.66 units/kg at 3 months, and 0.56 units/kg at 6 months.

These findings may assist with better insulin dosing for programs that have similar patient demographics and prednisone taper.