ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P214

Kidney transplantation and diabetes mellitus: continuous monitoring of glucose

Carla Baptista1, Margarida Bastos1, Joana Guimarães1, Patricia Leitão1, Miguel Melo1, Jacinta Santos1, Luisa Barros1, Carlos Bastos2, Rui Alves3, Francisco Carrilho1, Alfredo Mota2 & Manuela Carvalheiro1

1Endocrinolgy, Diabetes and Metabolism Department, HUC, Coimbra, Portugal; 2Urolgy and Transplantation Department, HUC, Coimbra, Portugal; 3Nephrology Department, HUC, Coimbra, Portugal.

Introduction: The benefits of intensive management of type 1 and type 2 diabetes have been well established in several studies, as DCCT and UKPDS, and include reduced of long term complications. Current guidelines target of A1c<7% is also to achieve in diabetic patient with kidney transplant. Methods to improve patient’s ability to achieve this goal are being explored. Continuous monitoring of glucose in interstitial fluid allows the identification of glycemic excursions and general patterns of glucose levels in a manner not available with self-monitoring blood glucose. Knowledge of these excursions and patterns may be used to make appropriate changes in treatment of diabetes.

Patients and methods: Continuous monitoring of glucose in interstitial fluid with MiniMed-CGMS was performed in two patients with type 1 diabetes and a kidney transplant. Both patients had A1c>7% and were under intensive therapy.

Results: Reported CGMS download were analyzed. We identified ‘down phenomen’, undetectable hypoglycaemia events, incorrect adjustments insulin therapy… Therapy adjustments based on this information were done. No mechanical device or local complaints were reported. After six month, glycemic control improved (A1c<7%).

Conclusions: Continuous monitoring of glucose is an important tool in intensive management of diabetes. This technology should be performed in all diabetic patients when goals are not achieved. It helps health team to make therapy adjustments and can improve patients’ glycemic control. This is the way to stopped progression of macro and microvascular complications that are present in diabetic patients as those with kidney transplant.