Metabolic assessment in clinical islet transplantation (CIT) has primarily been limited to the research setting. However, technological advances may now allow for this in routine practice. We describe here flash glucose monitoring (FGM) in islet transplant recipients with varying degrees of graft function as assessed by BETA-2 score (validated clinical index, range 0-42).

Method: Sensor data from 3 of 6 patients using FGM (Abbott FreeStyle Libre) at our center were available for this descriptive study. BETA-2 score was calculated from most recent A1c, insulin dose, fasting C-peptide and glucose.

Results: Patients (1,2,3) varied in age (68,49, 66 years), diabetes duration (59, 37, 48 years), total CITs (5, 2, 2), time from last CIT (28, 10, 1 months) and BETA-2 score (3.4, 10, 34). Patient 3 was insulin independent. FGM profile also varied and appeared to be related to BETA-2 score with improved mean glucose (7.8, 7.3, 5.2 mmol/L), time spent in target (4-8 mmol/L) (40,47, 97%) and decreased frequency/severity of hypoglycemia (Figure) with increasing BETA-2 score.

Conclusion: These observations are in line with previous studies showing an association between graft function (based on stimulated C-peptide) and continuous glucose monitoring and points to the potential of FGM and the BETA-2 score, which can be done in routine clinical care, to characterize graft function and glycemia post CIT.
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Disclosure

A. Lam: None. S. Forbes: None. C. Hamming: None. A.J. Malcolm: None. A. Shapiro: Consultant; Self; Viacyte, Inc., Protokinetix. P.A. Senior: Consultant; Self; Abbott, AstraZeneca. Research Support; Self; AstraZeneca, Prometic Life Sciences Inc., Novo Nordisk Inc., Sanofi. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company, Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc., Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; AstraZeneca, Merck & Co., Inc., Abbott. Research Support; Self; Viacyte, Inc..

© 2018 by the American Diabetes Association.
2018
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