Introduction and Objective: Glycemia management early after liver transplantation (LTx) is challenging due to patients’ critical state and corticoid therapy. We evaluated the impact of actively used real-time continuous glucose monitoring (CGM) on glycemic control in LTx recipients at postoperative ICU in a prospective randomized trial (clinicaltrials.gov NCT05585801).Methods: LTx recipients were randomized to wearing an open-labelled or blinded CGM (Dexcom G6) added to standard care, placed in the infraclavicular region immediately after surgery. Data from the open-labelled CGM were used to adjust insulin therapy; blinded CGM data served as controls. Primary endpoint was > 7.5% difference in time in the target range 6-10 mmol/l.Results: We included 154 patients, 12 were excluded due to technical failures (6 from each arm), 142 patients were evaluated (active CGM n=82, control n=60), 28% with diabetes. All required vasopressors, mechanical ventilation and intravenous insulin therapy after transplantation. Patients with actively used CGM spent significantly more time in the target range compared to the control group (68.5% vs. 60.3%, p=0.003), meeting the primary endpoint, and significantly less time in level 1 hyperglycemia, see Table 1.Conclusion: Active use of CGM added to standard therapy significantly improved glycemic control in patients in critical state early after liver transplantation.
B. Hagerf (Voglová): None. M. Protus: None. L. Nemetova: None. M. Mraz: None. P. Girman: Speaker’s Bureau; Neovii. M. Haluzik: Research Support; Sanofi. Advisory Panel; Eli Lilly and Company. Speaker’s Bureau; Novo Nordisk, Abbott. Advisory Panel; AstraZeneca. Speaker’s Bureau; GlaxoSmithKline plc, Amgen Inc. Advisory Panel; Bausch Health. J. Franekova: None. A. Jabor: None. E. Kieslichova: None.
CarDia (Programme EXCELES, Project No. LX22NPO5104); Funded by the European Union; Next Generation EUCooperatio Program, Charles University in Prague
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