Jandovitz Nicholas, George Sam J, Abate Mersema, Kressel Adam M, Bolognese Alexandra C, Lau Lawrence, Nair Vinay, Grodstein Elliot
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA.
The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA.
Clin Transplant. 2023 Dec;37(12):e15139. doi: 10.1111/ctr.15139. Epub 2023 Sep 19.
This study examines whether the use of inpatient Continuous Glucose Monitors provides improved glycemic control over finger-stick glucose monitoring post-transplant.
This 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.
Groups 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.
In 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.
本研究旨在探讨移植后使用住院患者连续血糖监测仪是否比指尖血糖监测能更好地控制血糖。
这是一项单中心前瞻性随机对照试验，40例患者在移植后的前5天接受传统指尖血糖监测或使用美敦力Guardian Sensor 3进行连续监测。纳入的患者为诊断为糖尿病的成年肾移植受者。评估的终点包括移植后每日血糖中位数水平、高血糖（≥180mg/dL）和低血糖（≤80mg/dL）发作次数、移植后细菌感染次数和住院时间。
两组在人口统计学变量方面匹配良好。干预组的每日血糖中位数显著更低。术后第2、3、4和5天的高血糖发作次数也显著更少。低血糖发生率、术后细菌感染率或住院时间无差异。
在这项随机研究中，使用连续血糖监测仪指导移植后血糖管理，在移植后的前5天显著降低了高血糖发作的发生率和血糖中位数水平，且未增加低血糖发作次数。在肾移植后即刻可考虑使用这些设备。
