Continuous glucose monitoring analysis as predictor of islet yield and insulin requirements in autologous islet transplantation after complete pancreatectomy
Autor: | Manuel Beltrán del Río, Renee Cercone, George Ivanov Georgiev, Horacio Rilo, Mukesh Tiwari |
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Rok vydání: | 2014 |
Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment Biomedical Engineering Urology Islets of Langerhans Transplantation Bioengineering Transplantation Autologous Pancreatectomy Internal medicine Blood Glucose Self-Monitoring Pancreatitis Chronic Internal Medicine Medicine Humans Hypoglycemic Agents Insulin Pancreatitis chronic geography geography.geographical_feature_category business.industry Continuous glucose monitoring nutritional and metabolic diseases Time ratio Original Articles Islet medicine.disease Transplantation Endocrinology Treatment Outcome Female business |
Zdroj: | Journal of diabetes science and technology. 8(6) |
ISSN: | 1932-2968 |
Popis: | We analyzed the pretransplant continuous glucose monitoring (CGM) data of 45 patients that underwent total pancreatectomy followed by autologous islet transplantation (AIT) at the University of Arizona Medical Center. Traditional and novel metrics of CGM time series were correlated to the total islet count (TIC), islet equivalents (IEQs), and weight-normalized IEQs (IEQ/kg). In a subset cohort (n = 26) we analyzed the relationship among the infused number of islets, the CGM indicators, and the first recorded insulin requirement after the procedure. We conclude that receiving a high islet yield is sufficient yet not necessary to achieve low or null insulin requirements within the first 50 days after surgery. Furthermore, CGM inertia and CGM length of curve (2 novel CGM indicators) are shown to be correlated to islet yield, and the CGMs normalized area ( Ao) and time ratio above hyperglycemic level ( To) are strongly correlated to insulin requirement. A screening test based on To is shown to have 100% sensitivity and 88% specificity discriminating insulin independence upon discharge. |
Databáze: | OpenAIRE |
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