Comparison of glycemic variability, assessed by continuous glucose monitoring system (CGMS) during early post-transplantation period, between the recipients of kidney and liver transplantation

Abstract

Introduction: Newly developed hyperglycemia and worsening of previously well-controlled glucose levels are common after transplantation because of the stressful conditions and use of immunosuppressive agents including high- or medium-dose glucocorticoids. However, to our knowledge, there are no data showing the degree of glucose fluctuation after transplantation according to the transplanted organ during the early postoperative period in non-diabetic or preexisting diabetic patients. Method: We conducted a retrospective, observational study to characterize the patterns of glucose profiles of transplant patients who underwent kidney or liver transplantation at our hospital between September 2017 and May 2018. Patients to whom a CGMS was attached during a postoperative period of approximately one month after transplantation were included. The CGM data of 31 patients including 24 with kidney transplantation (KT) and seven with liver transplantation (LT) were analyzed. Result: Post-transplantation diabetes mellitus (PTDM) occurred in 42.1% (8/19) and 16.7% (1/6) of KT and LT patients, respectively, during this early period after transplantation, except for patients with preexisting diabetes (5 KT, 1 LT). Glycemic variability after LT was better than that in KT patients. The average mean amplitude of glycemic excursion (MAGE) and mean absolute glucose (MAG) levels were 91.18±26.51 vs. 65.66±22.55 (P<0.05), 24.62±7.78 vs. 18.18±7.07 (P<0.05) in KT vs.LT patients, respectively, in patients without preexisting DM or PTDM patients. When PTDM or preexisting DM patients were included, significant differences of glycemic fluctuation between KT and LT were not observed. Conclusion: Our study was limited to the early post-transplantation period. Further studies involving CGM follow-up at regular intervals based on the time since transplantation and comparison of glycemic variability in PTDM or preexisting diabetic patients after KT or LT may clarify the role of transplanted organs in glucose control in recipients of organ transplants.