Glycemic variability indices can be used to diagnose islet transplantation success in type 1 diabetic patients

Détails

ID Serval
serval:BIB_031FC5E93427
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Glycemic variability indices can be used to diagnose islet transplantation success in type 1 diabetic patients
Périodique
Acta Diabetol
Auteur⸱e⸱s
Jalbert M., Zheng F., Wojtusciszyn A., Forbes F., Bonnet S., Skaare K., Benhamou P. Y., Lablanche S.
Collaborateur⸱rice⸱s
Trimeco Study Group
ISSN
1432-5233 (Electronic)
ISSN-L
0940-5429
Statut éditorial
Publié
Date de publication
03/2020
Volume
57
Numéro
3
Pages
335-345
Langue
anglais
Notes
Jalbert, Manon
Zheng, Fei
Wojtusciszyn, Anne
Forbes, Florence
Bonnet, Stephane
Skaare, Kristina
Benhamou, Pierre-Yves
Lablanche, Sandrine
eng
Randomized Controlled Trial
Germany
Acta Diabetol. 2020 Mar;57(3):335-345. doi: 10.1007/s00592-019-01425-3. Epub 2019 Oct 10.
Résumé
AIMS: High glycemic variability (GV) is the major indication for islet transplantation (IT) in patients with type 1 diabetes (T1D). The actual criteria used to assess graft function do not consider GV improvement. Our study aimed to describe GV indices' evolution in T1D patients who benefited from IT during the TRIMECO trial and to evaluate if thresholds might be defined to diagnose IT success. METHODS: We collected data from 29 patients of the TRIMECO trial, a clinical trial (NCT01148680) comparing the metabolic efficacy of IT with intensive insulin therapy. Based on CGM data, we analyzed mean glucose level and four GV indices (standard deviation, coefficient of variation, MAGE and GVP) before (M0) and 6 months (M6) after IT. RESULTS: Each GV index decreased significantly between M0 and M6: SD 53.9 mg/dL [44.6-61.5] versus 20.1 mg/dL [13.5-24.3]; CV 35.2% [30.6-37.7] versus 17.3% [12.0-20.5]; MAGE 134.9 mg/dl [111.2-155.8] versus 51.9 mg/dL [32.4-62.4]; GVP 35.3% [24.9-47.2] versus 12.2% [6.2-18.8] (p </= 0.0001). Thresholds diagnosing IT success at 6 months post-transplant were an SD at 22.76 mg/dL (sensibility 88.89%, specificity 80.00%), a CV at 17.47% (sensibility 88.89%, specificity 70.00%), a MAGE at 54.81 mg/dL (sensibility 88.89%, specificity 80.00%) and a GVP at 12.27% (sensibility 88.89%, specificity 70.00%). CONCLUSIONS: This study confirms a positive impact of IT on GV. The proposed thresholds allow an easy evaluation of IT success using only CGM data and may be a clinical tool for the follow-up of transplanted patients.
Mots-clé
Adult, Blood Glucose/metabolism, Diabetes Mellitus, Type 1/drug therapy/metabolism/*therapy, Female, Glycemic Index, Humans, Insulin/administration & dosage, *Islets of Langerhans Transplantation, Male, Middle Aged, *Brittle diabetes, *Continuous glucose monitoring, *Glycemic variability, *Islet transplantation
Pubmed
Création de la notice
14/06/2021 9:58
Dernière modification de la notice
18/09/2021 6:38
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