977-P: Continuous Glucose Monitoring in the Early Post–Lung Transplantation Period Free

Objective: Post-Transplant Diabetes Mellitus (PTDM) occurs in an estimated 20-40% of lung transplantation within five years, and hyperglycemia adversely affects outcomes, including rejection, infection, cardiovascular events, and mortality. Whereas continuous glucose monitoring (CGM) is common in patients with type 1 and type 2 diabetes mellitus, there is a significant knowledge gap in its application to PTDM. The objective of this study was to evaluate the performance of CGM in detecting hypoglycemia and hyperglycemia in the early post-lung transplantation period, compared with self-monitoring blood glucose.

Research and Design Methods: We conducted a prospective pilot study with patients aged 18-75 who underwent lung transplantation and had hyperglycemia managed with insulin. Enrolled patients wore a blinded CGM at discharge and self-monitored glucose levels at home for 10 days. Data were summarized according to the following categories and compared across both tests using the paired t-test: % time in range (70-180 mg/dl); % high (181-250 mg/dl); % very high (>250 mg/dl); % low (50-69 mg/dl); % very low (<50 mg/dl).

Results: The sample included 15 patients (mean age 58.6 years; 53.3% men; 73.3% with pre-transplantation diabetes). There was a significantly higher rate of detection for hyperglycemia with CGM use vs. self-monitored blood glucose. For the “% very high” group, the mean difference was 7.12, (95% confidence interval [CI], 1.8-12.4), and for the “% high” group, the mean difference was 11.1, (95% CI, 3.5-18.8), and for the combined group, “% high and % very high”, the mean difference was 18.3, (95% CI: 7.37-29.24). There was no statistically significant difference for the “% low and % very low” groups.

Conclusions: CGM demonstrated a higher rate of detection for hyperglycemia compared to self-monitoring blood glucose. The mean difference for hypoglycemia detection was not significant. Larger studies are required to provide statistically meaningful conclusions about CGM in PTDM.