A randomized trial of continuous glucose monitoring to improve post‐transplant glycemic control

• DOI: 10.1111/ctr.15139
• Publication Date: 2023-09-19T19:04:59Z
• Authors: Nicholas Jandovitz; Sam J. George; Mersema Abate; Adam M. Kressel; Alexandra C. Bolo...; Lawrence Lau; Vinay Nair; Elliot Grodstein
• Keywords: Adult; Blood Glucose; Blood Glucose Self-Monitoring; Continuous Glucose Monitoring; Humans; Hypoglycemic Agents; Insulin; Glycemic Control; Prospective Studies; Bacterial Infections; Hypoglycemia; 3. Good health

AbstractIntroductionThis study examines whether the use of inpatient Continuous Glucose Monitors provides improved glycemic control over finger‐stick glucose monitoring post‐transplant.MethodsThis is a single‐site, prospective randomized controlled trial of 40 patients receiving conventional finger‐stick glucose monitoring or continuous monitoring using the Medtronic Guardian Sensor 3 during the first 5 days post‐transplant. Included patients were adult renal transplant recipients with a diagnosis of diabetes. Assessed endpoints included post‐transplant daily median glucose level, hyperglycemic (≥180 mg/dL) and hypoglycemic (≤80 mg/dL) episodes, number of post‐transplant bacterial infections and length of stay.ResultsGroups were well matched in demographic variables. Median daily glucose was significantly lower in the intervention group. There were also significantly less episodes of hyperglycemia on postoperative days 2, 3, 4, and 5. There were no differences in the incidences of hypoglycemia, postoperative bacterial infections, or length of stay.ConclusionIn this randomized study, the use of a continuous glucose monitor to guide post‐transplant glucose management significantly lowered the incidence of hyperglycemic episodes and median glucose levels through the first 5 days post‐transplant without increasing the number of hypoglycemic episodes. The use of these devices can be considered in the immediate post‐renal transplant setting.