Glycemic Control and Variability of Diabetes Secondary to Total Pancreatectomy Assessed by Continuous Glucose Monitoring.
J Clin Endocrinol Metab. 2020 Oct 14;:
Authors: Juel CTB, Dejgaard TF, Hansen CP, Storkholm JH, Vilsbøll T, Lund A, Knop FK
Abstract
CONTEXT: The extent of the glycemic variability in diabetes secondary to total pancreatectomy is not fully understood.
OBJECTIVE: To evaluate glycemic variability in totally pancreatectomized (PX) patients and compare it to glycemic variability in HbA1c-matched patients with long-standing type 1 diabetes (T1D).
DESIGN: a case-control study was performed.
SETTING: Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen.
PATIENTS OR OTHER PARTICIPANTS: Ten PX patients (mean(SEM): age 64.3(9.8) years; Body Mass Index (BMI) 34.4(5.0) kg/m 2; duration of diabetes 3(2.8) years), 10 HbA1c-matched patients with T1D (63.9(8.6) years; 24.6(3.1) kg/m 2; 22(4) years) and 10 gender, age and BMI-matched healthy controls (CTRLs), All patients were managed on multiple daily injections of insulin.
INTERVENTION: Continuous glucose monitoring (CGM) (Medtronic MiniMed iPro 2) during twelve consecutive days.
MAIN OUTCOME MEASURES: Glycemic Variability.
RESULTS: HbA1c levels were similar in the PX group and the T1D group. The PX group had greater CONGA60min compared to the T1D group (mean(SEM): 9.5(0.3) vs 8.3(0.2) mmol/L, P<0.003) and mean plasma glucose values were higher in the PX group (10.6(0.9) vs 9.0(0.9) mmol/L, P<0.001) while CVpg and SDpg, respectively, were similar in the two groups. Time spent below range was not different between the PX and the T1D group (2.3(0.8) vs 4.5(0.8) %, P=0.065) while time spent above range was higher in the PX group (51.4(3.3) vs 37.6(1.9) %, P<0.001).
CONCLUSIONS: CGM-assessed glycemic variability showed higher CONGA60 min and time spent above range in our PX patients compared with HbA1c-matched T1D patients.
PMID: 33053154 [PubMed - as supplied by publisher]
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