Clinical Accuracy of Continuous Glucose Monitoring Immediately After Kidney Transplant in Patients With Type 2 Diabetes

Qurrat-Ul-Ain Aziz; Kavita Batra; Sanna Fatima; Jared Splinter; Amber Laurel Champion; Ajay M Kumar; Kenneth E Izuora

doi:10.1016/j.eprac.2025.04.022

Clinical Accuracy of Continuous Glucose Monitoring Immediately After Kidney Transplant in Patients With Type 2 Diabetes

Endocr Pract. 2025 May 7:S1530-891X(25)00142-9. doi: 10.1016/j.eprac.2025.04.022. Online ahead of print.

Authors

Qurrat-Ul-Ain Aziz¹, Kavita Batra², Sanna Fatima¹, Jared Splinter³, Amber Laurel Champion¹, Ajay M Kumar⁴, Kenneth E Izuora⁵

Affiliations

¹ Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.
² Department of Medical Education and Office of Research, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.
³ Department of Pharmaceutical Services, University Medical Center of Southern Nevada, Las Vegas, Nevada.
⁴ Joslin Diabetes Center, Affiliate at Baptist Health Floyd, New Albany, Indiana.
⁵ Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada. Electronic address: Kenneth.izuora@unlv.edu.

PMID: 40345580
DOI: 10.1016/j.eprac.2025.04.022

Abstract

Objective: To evaluate the accuracy of a blinded continuous glucose monitoring (CGM) device compared with point-of-care testing (POCT) and serum glucose measurements in the immediate postoperative period among kidney transplant recipients with type 2 diabetes mellitus (DM).

Methods: In this prospective study, we enrolled 22 participants aged ≥18 years, with type 2 DM, immediately after kidney transplant. We applied a blinded CGM device that sampled interstitial glucose every 15 minutes and collected POCT and serum glucose values. Using matched pairs of glucose readings between CGM and POCT and between CGM and serum glucose, we calculated bias and absolute relative difference and conducted a Clarke Error Grid Analysis.

Results: Eighty-two percent of the participants were male, with a mean age of 58 ± 9.69 years, mean body mass index of 30 ± 6.41 kg/m², and baseline mean A1C level of 6.7 ± 1.07%. The mean durations of type 2 DM and end-stage kidney disease were 19 ± 10.6 and 3 ± 2.27 years, respectively. There were 327 and 72 matched pairs of CGM/POCT and CGM/serum glucose data, respectively. Clarke Error Grid Analysis comparing CGM/POCT showed 83.79% of values in zone A and 15.29% in zone B (combined 99.08%), with a mean absolute relative difference of 13.24%. For CGM/serum glucose, values of 83.1% were in zone A, and values of 16.9% were in zone B (combined 100%), with a mean absolute relative difference of 13.10%.

Conclusion: CGM provided accurate blood glucose measurements compared with POCT and serum glucose values in patients with type 2 DM after kidney transplant. When used in this patient population, CGM devices have the potential to improve clinical outcomes through earlier detection and intervention for glycemic excursions.

Keywords: continuous glucose monitoring; kidney transplant; type 2 diabetes.