Continuous Glucose Monitoring Before and After Simultaneous Pancreas-Kidney Transplantation: Insights from a Real-World Clinical Setting.

INTRODUCTION

Simultaneous pancreas-kidney (SPK) transplantation normalizes glycemia in patients with diabetes and end-stage kidney disease, yet data on continuous glucose monitoring (CGM) remain scarce.

METHODS

We retrospectively analyzed CGM metrics in SPK recipients using FreeStyle Libre 2®, comparing pre- and post-transplant profiles.

RESULTS

Among n = 19 recipients, only n = 14 continued CGM use after transplantation (n = 9 continuously during the entire study period). Within 1 month, all CGM metrics improved significantly, including increased time-in-range (54.21 vs. 83.85%) and time-in-tight-range (TITR; 33.45 vs. 69.77%), and reduced glucose variability (p < 0.05 for all comparisons), with stability over 24 months. Optimal graft function was associated with superior CGM outcomes, notably higher TITR and lower mean amplitude of glycemic excursions (MAGE; p < 0.05). However, hypoglycemia-related targets were not consistently achieved despite otherwise optimal graft performance.

CONCLUSIONS

SPK transplantation was linked to rapid and sustained improvement in CGM profiles. These findings underscore CGM's value for monitoring graft function and support its integration into post-transplant care to optimize metabolic outcomes.