Endocrinology Section, Department of Pediatrics, Baylor College of Medicine , Houston, Texas, USA.
Diabetes Technol Ther. 2010 May;12(5):347-51. doi: 10.1089/dia.2009.0157.
Simultaneous pancreas-kidney (SPK) transplantation is an important replacement therapy for individuals with diabetes and end-stage renal disease. Kidney-alone (KA) transplantation is associated with a high incidence of post-transplant diabetes.
This was a cross-sectional study. We studied 48-h glucose concentrations in eight subjects with type 1 diabetes mellitus after SPK transplantation, six subjects post-KA transplantation, and nine healthy controls using the CGMS (Medtronic Minimed, Northridge, CA) continuous glucose monitoring system.
The 48-h mean glucose concentration was 101 +/- 7 mg/dL in the SPK subjects, 105 +/- 12 mg/dL in the KA subjects, and 99 +/- 7 mg/dL in the healthy controls. The glycemic excursions were higher in the KA group compared to the SPK cohort and healthy controls (P < 0.0001). No differences in the incidence of hypoglycemia were detected among the three groups. Significant postprandial hyperglycemia was uncovered in four of the six KA subjects.
SPK transplantation is very effective at normalizing glycemic excursions. Unsuspected hyperglycemia was identified in the KA group. The CGMS was a useful ambulatory tool to study glucose profiles in the post-transplant period and may help uncover hyperglycemia undetected by routine laboratory testing.
胰肾联合（SPK）移植是治疗糖尿病和终末期肾病患者的重要替代疗法。单独肾移植（KA）与移植后糖尿病的高发病率相关。
这是一项横断面研究。我们使用 CGMS（美敦力 Minimed，加利福尼亚州北岭）连续血糖监测系统研究了 8 例 1 型糖尿病患者 SPK 移植后、6 例 KA 移植后和 9 例健康对照者的 48 小时葡萄糖浓度。
SPK 组受试者的 48 小时平均血糖浓度为 101 ± 7mg/dL，KA 组受试者为 105 ± 12mg/dL，健康对照组为 99 ± 7mg/dL。KA 组的血糖波动高于 SPK 队列和健康对照组（P < 0.0001）。三组之间未检测到低血糖发生率的差异。在六个 KA 受试者中，有四个出现了明显的餐后高血糖。
SPK 移植非常有效地使血糖波动正常化。KA 组发现了未被察觉的高血糖。CGMS 是一种有用的动态工具，可用于研究移植后期间的血糖谱，并可能有助于发现常规实验室检测未检测到的高血糖。
