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Master Thesis

Analyse des scores de variabilité glycémique dans une population de patients diabétiques de type 1 avant et après transplantation d’ilots pancréatiques et apport dans le diagnostic de succès de greffe

Abstract : Aims: High glycemic variability (GV) is the major indication for islet transplantation (IT) in type 1 diabetic (T1D) patients but the actual criterion used to assess graft function does 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 predict IT’s success. Methods: We collected data from 29 patients of the TRIMECO trial (NCT01148680), a clinical trial comparing the metabolic efficacy of IT with intensive insulin therapy. Based on CGM data, we analysed 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 indice decreased significantly between M0 and M6 : SD 53.9 mg/dL vs 20.1 mg/dL; CV 35.2% vs 17.3%; MAGE 134.9 mg/dl vs 51.9 mg/dL; GVP 35.3% vs 12.2% (p ≤ 0.0001). Thresholds predicting IT’s success at 6 months post-transplant were : SD 21.51 mg/dL (sensibility Se 86.67%, specificity Spe 92.86%), CV 16.03% (Se 86.67%, Spe 71,43%), MAGE 54.81 mg/dL (Se 73.33%, Spe 92.86%) and GVP 15.78% (Se 73.33%, Spe 100%). Conclusions: This study confirms a positive impact of IT on GV of T1D patients. The proposed thresholds allow an easy evaluation of IT’s success using only CGM data and may be a clinical tool for the follow-up of transplanted patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02420830
Contributor : Jean-Hugues Morneau <>
Submitted on : Friday, December 20, 2019 - 10:26:16 AM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
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Manon Jalbert. Analyse des scores de variabilité glycémique dans une population de patients diabétiques de type 1 avant et après transplantation d’ilots pancréatiques et apport dans le diagnostic de succès de greffe. Médecine humaine et pathologie. 2019. ⟨dumas-02420830⟩

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