SHABAN A1, SUNDERLAND A1, MINAS K1, ISARD T1, DANIELS G, CHAN D1, LIM W1, CHAKERA A1
1Sir Charles Gairdner Hospital, Perth/Nedlands , Australia
Aim: We aim to prospectively describe patterns of glycaemia after transplantation, to assess accuracy of flash glucose monitoring (FGM) in detection of glycaemic events, and to assess patient experiences of continuous glucose monitoring FGM.
Background: Poor glycaemic control is associated with worse clinical outcomes in kidney transplant recipients, including increased risks of cellular rejection, graft loss and death.
Methods: From 1.10.2020 till 1.4.2021, all renal transplant recipients were recruited in the study. FGM was applied in the perioperative period. Fasting blood glucose BG was measured daily, and capillary blood glucose (CBG) was measured at least four times a day. FGM was scanned every time CBG obtained. The 24-h BG profile was assessed by FGM. All adverse events were recorded. Patients’ and nurses’ satisfaction was measured by questionnaire.
Results: From the 14 patients recruited, 442 measurements of capillary BG were obtained (average 31.5 per patient). Three episodes of hypoglycaemia (glucose <4.0 mmol/l) were detected, none were missed by the FGM. Hyperglycaemia >11.0 mmol/l occurred 68 times in 9 patients (64%). FGM readings were lower than capillary BG by an average of 1.22 mmol/L (95% CI 0.72-1.72), with no significant excursions. Evening readings were the highest (10.2mmol/l; 95% CI 8.8-11.6). Using 5 points preference questionnaire, patients and nurses were highly satisfied with the usability and convenience of FGM devices, and all preferred FGM over capillary BG testing.
Conclusions: Dysglycaemia is common after renal transplantation. FGM is an accurate and convenient tool that can be useful in transplant patients. FGM is slightly lower than CGM in keeping with published data. Patients demonstrated strong preference to FGM over CBS.
Awf is graduated from Tikrit Medical School in Iraq, then had cardiology masters and fellowship from Malaysia, before coming to Australia and joining RACP. He is currently Nephrology Advance Trainee at Sir Charles Gairdner Hospital.