Introduction: Hirsch, et al1 used continuous glucose monitoring (CGM) parameters to accurately calculate the personal glycemic state (PGS) of patients with diabetes. We modified this model to see if it can predict the need for islet transplantation (IT) for patients with type 1 diabetes (T1D).
Method: Weighting the glycemic control components used in Hirsch, et al model1, as well as confining the percent time in range to 70-140 mg/dl, result in a PGS score of 15 (IT suitability score; PGSITSS) below which glycemic control is consistent with nondiabetics, and above which it identified T1D patients with frequent episodes of hypoglycemia and hypoglycemia unawareness (current indication for IT need).
Results: Applying this model to data of 31 subjects with T1D transplanted based on the traditional criteria, successfully predicted need for first IT in 16/17 (94%) and subsequent IT in 12/15 (80%), as well as insufficient glycemic control post final IT in 8 subjects consistent with other metabolic assessments. In contrast, the original model with the same cutoff identified only 12 (71%), 3 (20%) and 3 subjects, respectively (Fig 1). Overall results showed concordance between the two models where PGS improved significantly from pre to post IT.
Conclusion: PGSITSS can accurately estimate need for IT and could replace the traditional criteria for patient eligibility.
1. Hirsch IB, et al. Diabetes Technol Ther. 2017;19(S3): S38-S48.
C. Orr: None. J. Hacker-Stratton: None. J.L. Truong: None. N.A. Mimila-Orozco: None. N. Ferro: None. J. Trueblood: None. K. Omori: None. M. Qi: None. E. Forouhar: None. M.A. El-Shahawy: None. F.R. Kandeel: Advisory Panel; Vertex Pharmaceuticals Incorporated.
National Institutes of Health (U24DK098085)
