P-212 Poster of distinction

Continuous glucose monitoring (CGM) – a new tool for evaluation of ?-cell function in clinical islet autotransplantaiton

H. Rilo, M. Vardanyan, C. Gruessner, C. Desai, T. Jie, R. Gruessner, K. Khan, A. Gruessner
University of Minnesota, Minneapolis, USA

Objective: Total pancreatectomy (TP) and clinical islet autotransplantation (IAT) should be considered prior to exhaustion of ?-cell mass in patients with unremitting pain of severe chronic pancreatitis (CP). We compared hemoglobin A1C (HbA1C) and continuous glucose monitoring (CGM) values as indicators of islet ?-cell function in patients evaluated for pancreatectomy with or without clinical islet autotransplantation.

Methods: Measurements on patients and normal controls using CGM and HbA1C were correlated. CGM measurements used were percentage of time being above normal upper limit of glucose (> 120 mg/dl), below normal lower limit (< 65mg/dl) and associated areas, in addition with the average glucose level. A stepwise nonparametric discriminant analysis was applied to identify factors which distinguish the control group from the CP patients.

Results: Data was available for 32 patients with CP; 12 were male and 20 females. Additionally, CGM data were available for 8 controls. The HbA1C was below 6.5% in 24/32 (75%) of the CP patients (median 5.6%, range 4.7% - 13.0%) and in all controls (median 5,3%, range 5.3% - 5.6%). Very few hypoglycemic episodes were noted in the CP patients. The discriminant analysis only identified the relative duration above 120mg/dL out of all the different CGM measurements as significant between controls and CP patients. HbA1c was no discriminator. All controls were classified as normal (100%) and 94% of CP patients as belonging to the CP group. 22 out of 24 CP patients with normal HbA1c were classified as abnormal (92%). Figure 1 shows the distribution between relative duration above 120mg/dL and HbA1c for both groups.

Conclusion: CGM should be implemented as an evaluating tool for patients suffering from intractable pain of CP and being considered for TP/IAT to evaluate ? -cell mass and function.HbA1C alone is a poor predictor of remaining ?- cell mass in this patient population.

P-212 Poster of distinction

Continuous glucose monitoring (CGM) – a new tool for evaluation of ?-cell function in clinical islet autotransplantaiton

H. Rilo, M. Vardanyan, C. Gruessner, C. Desai, T. Jie, R. Gruessner, K. Khan, A. Gruessner
University of Minnesota, Minneapolis, USA

Objective: Total pancreatectomy (TP) and clinical islet autotransplantation (IAT) should be considered prior to exhaustion of ?-cell mass in patients with unremitting pain of severe chronic pancreatitis (CP). We compared hemoglobin A1C (HbA1C) and continuous glucose monitoring (CGM) values as indicators of islet ?-cell function in patients evaluated for pancreatectomy with or without clinical islet autotransplantation.

Methods: Measurements on patients and normal controls using CGM and HbA1C were correlated. CGM measurements used were percentage of time being above normal upper limit of glucose (> 120 mg/dl), below normal lower limit (< 65mg/dl) and associated areas, in addition with the average glucose level. A stepwise nonparametric discriminant analysis was applied to identify factors which distinguish the control group from the CP patients.

Results: Data was available for 32 patients with CP; 12 were male and 20 females. Additionally, CGM data were available for 8 controls. The HbA1C was below 6.5% in 24/32 (75%) of the CP patients (median 5.6%, range 4.7% - 13.0%) and in all controls (median 5,3%, range 5.3% - 5.6%). Very few hypoglycemic episodes were noted in the CP patients. The discriminant analysis only identified the relative duration above 120mg/dL out of all the different CGM measurements as significant between controls and CP patients. HbA1c was no discriminator. All controls were classified as normal (100%) and 94% of CP patients as belonging to the CP group. 22 out of 24 CP patients with normal HbA1c were classified as abnormal (92%). Figure 1 shows the distribution between relative duration above 120mg/dL and HbA1c for both groups.

Conclusion: CGM should be implemented as an evaluating tool for patients suffering from intractable pain of CP and being considered for TP/IAT to evaluate ? -cell mass and function.HbA1C alone is a poor predictor of remaining ?- cell mass in this patient population.