Continuous glucose monitoring after kidney transplantation in non-diabetic patients: early hyperglycaemia is frequent and may herald post-transplantation diabetes mellitus and graft failure

Détails

ID Serval
serval:BIB_51B8F044189B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Continuous glucose monitoring after kidney transplantation in non-diabetic patients: early hyperglycaemia is frequent and may herald post-transplantation diabetes mellitus and graft failure
Périodique
Diabetes Metab
Auteur⸱e⸱s
Wojtusciszyn A., Mourad G., Bringer J., Renard E.
ISSN
1878-1780 (Electronic)
ISSN-L
1262-3636
Statut éditorial
Publié
Date de publication
10/2013
Volume
39
Numéro
5
Pages
404-10
Langue
anglais
Notes
Wojtusciszyn, A
Mourad, G
Bringer, J
Renard, E
eng
France
Diabetes Metab. 2013 Oct;39(5):404-10. doi: 10.1016/j.diabet.2012.10.007. Epub 2013 Aug 30.
Résumé
OBJECTIVES: New onset of diabetes after transplantation (NODAT) is a known complication of renal transplantation, but early glycaemic status after transplantation has not been described prospectively. This study aimed to assess blood glucose (BG) levels immediately following kidney transplantation in non-diabetic subjects and to explore their relationship to later graft outcomes and NODAT occurrence. PATIENTS AND METHODS: Over a 9-month period, 43 consecutive non-diabetic patients who received a kidney transplant were prospectively investigated. During the first 4 days after transplantation, fasting BG was measured and the 24-h BG profile assessed by continuous glucose monitoring (CGM). Capillary BG was measured on hospital admittance and at least four times a day for CGM calibration thereafter. All adverse events were recorded, and fasting BG and HbA1c were assessed at 3, 6 and 12 months and at the last visit to our centre. RESULTS: Immediately following renal transplantation, capillary BG was 12.2 +/- 3.8 mmol/L. On day 1 (D1), fasting BG was 9.9 +/- 4.3 mmol/L and decreased to 6.0 +/- 1.5 mmol/L on D3. The CGM-reported mean 24-h BG (mmol/L) was 10.2+/-2.4 on D1, 7.7 +/- 1.3 on D2 and 7.5 +/- 1.1 on D3. From D1 to D4, 43% of patients spent>12h/day with BG levels>7.7 mmol/L. While morbidity during the 3 months following transplantation appeared unrelated to BG, the first post-transplantation capillary BG measurement and fasting BG on D1 tended to be higher in patients who developed diabetes 3 months later. Tacrolimus treatment was associated with a higher incidence of dysglycaemia at 3 and 6 months. After a mean follow-up of 72 months, NODAT was frequently seen (18.6%), and was associated with tacrolimus medication (P<0.01) and a higher rate of renal transplantation failure (RR: 3.6, P<0.02). CONCLUSION: Hyperglycaemia appears to be a nearly constant characteristic immediately following transplantation in non-diabetic kidney recipients. Higher BG values could identify patients at risk for later post-transplant diabetes and graft failure.
Mots-clé
Adult, Blood Glucose/*metabolism, Blood Glucose Self-Monitoring, Body Mass Index, Critical Care/methods, Diabetes Mellitus/*blood/epidemiology/etiology, Female, Follow-Up Studies, France/epidemiology, Glycated Hemoglobin A/metabolism, Graft Rejection/*blood/epidemiology, Humans, Hyperglycemia/*blood/epidemiology/etiology, Immunosuppressive Agents/administration & dosage/*adverse effects, Kidney Transplantation/*adverse effects, Male, Middle Aged, *Monitoring, Physiologic, Predictive Value of Tests, Prospective Studies, Risk Factors, Tacrolimus/administration & dosage/*adverse effects, Continuous glucose monitoring, Diabete post-transplantation, Hyperglycaemia, Hyperglycemie, Kidney transplantation, Mesure continue du glucose, New onset of diabetes after transplantation, Transplantation renale
Pubmed
Création de la notice
14/06/2021 9:59
Dernière modification de la notice
18/09/2021 6:38
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