Pancreas · 2024
Evaluating Continuous Glucose Monitoring After Total Pancreatectomy With or Without Islet Autotransplantation: A Scoping Systematic Review.
СтатьяScoping ReviewНазвание и аннотация: Перевод пока не подготовлен
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Bashir Ayat, Joseph Nejo, Hammond John S, White Steve, Abu-El-Haija Maisam, Drewes Asbjørn Mohr, Shaw James A M, Pandanaboyana Sanjay
Аннотация
OBJECTIVES: This scoping review aims to provide evidence synthesis of continuous glucose monitoring (CGM) and insulin pump use after undergone total pancreatectomy (TP) with or without islet autotransplantation (TPIAT).
METHODS: The review was conducted adhering to PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist.
RESULTS: Fifteen studies including 147 patients (adult n = 71/pediatric n = 76) reported on CGM use post-TP (n = 42) and TPIAT (n = 105). Four were randomized controlled trials and 10 observational studies. Six studies evaluated CGM use in the perioperative and 6 in the immediate postoperative period (n = 8) with variable follow-up (14 hours to 20 months). CGM was used as a stand-alone device (8 studies), which allowed assessment of glycemic variability (n=5) and detection of hypoglycemia (n = 1), resulting in lower glucose levels (n = 1). Six studies evaluated insulin pump with CGM with reduction in postoperative mean glucose (n = 4) and hypoglycemic episodes (n = 2). No patient-reported outcome measures (PROMs) or quality of life (QoL) measures were reported.
CONCLUSIONS: CGM can be used following TP for glucose monitoring and/or linked with insulin pump device in the perioperative period with improved glycemic control. However, the data are limited by short follow-up and lack of PROMs and QoL measures.
METHODS: The review was conducted adhering to PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist.
RESULTS: Fifteen studies including 147 patients (adult n = 71/pediatric n = 76) reported on CGM use post-TP (n = 42) and TPIAT (n = 105). Four were randomized controlled trials and 10 observational studies. Six studies evaluated CGM use in the perioperative and 6 in the immediate postoperative period (n = 8) with variable follow-up (14 hours to 20 months). CGM was used as a stand-alone device (8 studies), which allowed assessment of glycemic variability (n=5) and detection of hypoglycemia (n = 1), resulting in lower glucose levels (n = 1). Six studies evaluated insulin pump with CGM with reduction in postoperative mean glucose (n = 4) and hypoglycemic episodes (n = 2). No patient-reported outcome measures (PROMs) or quality of life (QoL) measures were reported.
CONCLUSIONS: CGM can be used following TP for glucose monitoring and/or linked with insulin pump device in the perioperative period with improved glycemic control. However, the data are limited by short follow-up and lack of PROMs and QoL measures.