Glycemic variability indices can be used to diagnose islet transplantation success in type 1 diabetic patients
Manon Jalbert
(1)
,
Fei Zheng
(2, 3)
,
Anne Wojtusciszyn
(4)
,
Florence Forbes
(5)
,
Stéphane Bonnet
(6)
,
Kristina Skaare
(7)
,
Pierre-Yves Benhamou
(8, 7)
,
Sandrine Lablanche
(8, 7)
1
UGA UFRM -
Université Grenoble Alpes - UFR Médecine
2 Inria Grenoble - Rhône-Alpes
3 DTBS - Département Microtechnologies pour la Biologie et la Santé
4 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
5 MISTIS - Modelling and Inference of Complex and Structured Stochastic Systems
6 CEA-LETI - Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information
7 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
8 LBFA - Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée
2 Inria Grenoble - Rhône-Alpes
3 DTBS - Département Microtechnologies pour la Biologie et la Santé
4 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
5 MISTIS - Modelling and Inference of Complex and Structured Stochastic Systems
6 CEA-LETI - Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information
7 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
8 LBFA - Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée
Fei Zheng
- Fonction : Auteur
- PersonId : 21574
- IdHAL : fei-zheng
- ORCID : 0000-0002-8677-9187
Florence Forbes
- Fonction : Auteur
- PersonId : 16305
- IdHAL : florence-forbes
- ORCID : 0000-0003-3639-0226
- IdRef : 12469781X
Résumé
Aims
High glycemic variability (GV) is the major indication for islet transplantation (IT) in patients with type 1 diabetes (T1D). The actual criteria used to assess graft function do not consider GV improvement. Our study aimed to describe GV indices’ evolution in T1D patients who benefited from IT during the TRIMECO trial and to evaluate if thresholds might be defined to diagnose IT success.
Methods
We collected data from 29 patients of the TRIMECO trial, a clinical trial (NCT01148680) comparing the metabolic efficacy of IT with intensive insulin therapy. Based on CGM data, we analyzed mean glucose level and four GV indices (standard deviation, coefficient of variation, MAGE and GVP) before (M0) and 6 months (M6) after IT.
Results
Each GV index decreased significantly between M0 and M6: SD 53.9 mg/dL [44.6–61.5] versus 20.1 mg/dL [13.5–24.3]; CV 35.2% [30.6–37.7] versus 17.3% [12.0–20.5]; MAGE 134.9 mg/dl [111.2–155.8] versus 51.9 mg/dL [32.4–62.4]; GVP 35.3% [24.9–47.2] versus 12.2% [6.2–18.8] (p ≤ 0.0001). Thresholds diagnosing IT success at 6 months post-transplant were an SD at 22.76 mg/dL (sensibility 88.89%, specificity 80.00%), a CV at 17.47% (sensibility 88.89%, specificity 70.00%), a MAGE at 54.81 mg/dL (sensibility 88.89%, specificity 80.00%) and a GVP at 12.27% (sensibility 88.89%, specificity 70.00%).
Conclusions
This study confirms a positive impact of IT on GV. The proposed thresholds allow an easy evaluation of IT success using only CGM data and may be a clinical tool for the follow-up of transplanted patients.
High glycemic variability (GV) is the major indication for islet transplantation (IT) in patients with type 1 diabetes (T1D). The actual criteria used to assess graft function do not consider GV improvement. Our study aimed to describe GV indices’ evolution in T1D patients who benefited from IT during the TRIMECO trial and to evaluate if thresholds might be defined to diagnose IT success.
Methods
We collected data from 29 patients of the TRIMECO trial, a clinical trial (NCT01148680) comparing the metabolic efficacy of IT with intensive insulin therapy. Based on CGM data, we analyzed mean glucose level and four GV indices (standard deviation, coefficient of variation, MAGE and GVP) before (M0) and 6 months (M6) after IT.
Results
Each GV index decreased significantly between M0 and M6: SD 53.9 mg/dL [44.6–61.5] versus 20.1 mg/dL [13.5–24.3]; CV 35.2% [30.6–37.7] versus 17.3% [12.0–20.5]; MAGE 134.9 mg/dl [111.2–155.8] versus 51.9 mg/dL [32.4–62.4]; GVP 35.3% [24.9–47.2] versus 12.2% [6.2–18.8] (p ≤ 0.0001). Thresholds diagnosing IT success at 6 months post-transplant were an SD at 22.76 mg/dL (sensibility 88.89%, specificity 80.00%), a CV at 17.47% (sensibility 88.89%, specificity 70.00%), a MAGE at 54.81 mg/dL (sensibility 88.89%, specificity 80.00%) and a GVP at 12.27% (sensibility 88.89%, specificity 70.00%).
Conclusions
This study confirms a positive impact of IT on GV. The proposed thresholds allow an easy evaluation of IT success using only CGM data and may be a clinical tool for the follow-up of transplanted patients.
Domaines
Sciences du Vivant [q-bio]Format du dépôt | Notice |
---|---|
Type de dépôt | Article dans une revue |
Résumé |
en
<b>Aims</b><br>
High glycemic variability (GV) is the major indication for islet transplantation (IT) in patients with type 1 diabetes (T1D). The actual criteria used to assess graft function do not consider GV improvement. Our study aimed to describe GV indices’ evolution in T1D patients who benefited from IT during the TRIMECO trial and to evaluate if thresholds might be defined to diagnose IT success.<br>
<b>Methods</b><br>
We collected data from 29 patients of the TRIMECO trial, a clinical trial (NCT01148680) comparing the metabolic efficacy of IT with intensive insulin therapy. Based on CGM data, we analyzed mean glucose level and four GV indices (standard deviation, coefficient of variation, MAGE and GVP) before (M0) and 6 months (M6) after IT.<br>
<b>Results</b><br>
Each GV index decreased significantly between M0 and M6: SD 53.9 mg/dL [44.6–61.5] versus 20.1 mg/dL [13.5–24.3]; CV 35.2% [30.6–37.7] versus 17.3% [12.0–20.5]; MAGE 134.9 mg/dl [111.2–155.8] versus 51.9 mg/dL [32.4–62.4]; GVP 35.3% [24.9–47.2] versus 12.2% [6.2–18.8] (p ≤ 0.0001). Thresholds diagnosing IT success at 6 months post-transplant were an SD at 22.76 mg/dL (sensibility 88.89%, specificity 80.00%), a CV at 17.47% (sensibility 88.89%, specificity 70.00%), a MAGE at 54.81 mg/dL (sensibility 88.89%, specificity 80.00%) and a GVP at 12.27% (sensibility 88.89%, specificity 70.00%).<br>
<b>Conclusions</b><br>
This study confirms a positive impact of IT on GV. The proposed thresholds allow an easy evaluation of IT success using only CGM data and may be a clinical tool for the follow-up of transplanted patients.
|
Titre |
en
Glycemic variability indices can be used to diagnose islet transplantation success in type 1 diabetic patients
|
Auteur(s) |
Manon Jalbert
1
, Fei Zheng
2, 3
, Anne Wojtusciszyn
4
, Florence Forbes
5
, Stéphane Bonnet
6
, Kristina Skaare
7
, Pierre-Yves Benhamou
8, 7
, Sandrine Lablanche
8, 7
1
UGA UFRM -
Université Grenoble Alpes - UFR Médecine
( 1043145 )
- Domaine de la Merci - 38706 La Tronche cedex
- France
2
Inria Grenoble - Rhône-Alpes
( 2497 )
- Inovallée
655 avenue de l'Europe
38330 Montbonnot
- France
3
DTBS -
Département Microtechnologies pour la Biologie et la Santé
( 40213 )
- France
4
CHRU Montpellier -
Centre Hospitalier Régional Universitaire [Montpellier]
( 258773 )
- 191 avenue du doyen Gaston Giraud 34295 Montpellier
- France
5
MISTIS -
Modelling and Inference of Complex and Structured Stochastic Systems
( 1043096 )
- Inria Grenoble - Rhône-Alpes 655 avenue de l'Europe - Montbonnot 38334 Saint Ismier Cedex
- France
6
CEA-LETI -
Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information
( 40214 )
- MINATEC 17, rue des Martyrs, 38054, Grenoble Cedex 9
- France
7
CHUGA -
Centre Hospitalier Universitaire [CHU Grenoble]
( 257328 )
- CS 10217
38043 Grenoble cedex 9
- France
8
LBFA -
Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée
( 1043297 )
- Bâtiment B Biologie, 2280 Rue de la Piscine, 38400 Saint Martin d'Hères
- France
|
Date de publication électronique |
2019-10-10
|
Volume |
57
|
Page/Identifiant |
335–345
|
Audience |
Internationale
|
Date de publication |
2020-03
|
Langue du document |
Anglais
|
Nom de la revue |
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Domaine(s) |
|
DOI | 10.1007/s00592-019-01425-3 |
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