Introduction: Glycemic management early after liver transplantation (LTx) is challenging due to the patients’ critical state and corticoid therapy and can be complicated by preexisting diabetes mellitus (DM). We analyzed data from continuous glucose monitoring (CGM) in LTx recipients from an ongoing prospective trial (ClinicalTrials.gov NCT05585801), assessing the impact of CGM use on postoperative glucose control.
Methods: Patients undergoing LTx were randomized to a blinded or open-labelled CGM (Dexcom G6, San Diego, USA), used in addition to standard care. Protocol-based i.v. insulin therapy was used for glycemic management with CGM data helping insulin titration in the open arm. We compared CGM metrics between the study arms and in the subgroup of patients with pre-transplant DM. Mann-Whitney, t-test and Fisher test were used for data analysis.
Results: We included 108 LTx recipients (30 with DM). Baseline characteristics and CGM metrics are shown in Table 1. Overall CGM use was 97% of time, with 4 cases of sensor failure. Open-labelled CGM use was associated with reduced average glycemia and improved time in range in the subgroup of patients with DM, with a similar, albeit insignificant, tendency in the whole group.
Conclusion: Our study shows that integration of CGM in postoperative ICU care improved glycemic control in patients with DM after LTx, with a similar trend in the whole LTx recipient cohort.
M. Protus: None. L. Nemetova: None. M. Mraz: None. M. Haluzik: Advisory Panel; Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Johnson & Johnson Medical Devices Companies. Consultant; Merck & Co., Inc., Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Johnson & Johnson Medical Devices Companies, Novatin. Research Support; Sanofi. Speaker's Bureau; Sanofi, Novo Nordisk. P. Girman: None. V. Svirlochova: None. J. Franekova: None.
Cooperatio Programme, section Medical Diagnostics and Basic Medical Sciences, Charles University, Prague, Czech Republic and by National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, ID Project No. LX22NPO5104) - Funded by the European Union – Next Generation EU) MH CZ - DRO ("Institute for Clinical and Experimental Medicine – IKEM, IN 00023001")
