Русский
Safety of continuous glycemic monitoring system in patients after total duodenopancreatectomy in the early postoperative period. Single-center retrospective cohort study
DOI: https://dx.doi.org/10.18565/pharmateca.2024.2.142-148
Farmanov A.G., Bublik E.V., Vinogradskaya O.I., Udovichenko O.V., Zilov A.V., Ryzhkova E.G., Egorov V.I., Fadeev V.V., Deune-zheva S.M., Zhivov A.V., Tobianskaya I.E.
1) Ilyinskaya Hospital, Moscow region, Krasnogorsk, Russia; 2) I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
Background. Among the various types of pancreatogenic diabetes mellitus, the greatest difficulties in glycemic control arise in patients after total duodenopancreatectomy (TDPE). This is associated to the presence of an absolute deficiency of insulin secreted by β-cells and a lack of glucagon secreted by α-cells of the pancreas.
Objective. Evaluation of the safety of using the Guardian Connect continuous glucose monitoring (CGM) system in the early postoperative period in patients after TDPE.
Methods. A retrospective assessment of glucose values recorded in the electronic medical record of 28 patients after TDPE who were followed-up in the clinic from 2020 to 2023 was carried out. In group 1, 13 patients were monitored for glycemic control using the Guardian Connect CGM system (in parallel with the use of a glucometer). In group 2, 15 patients underwent glycemic control only using a glucometer.
Results. Intravenous insulin therapy: glucose levels in group 1 were statistically significantly more likely to be in the target range of 5.6–10.0 mmol/L (p = 0.005) and in the range from 4.3 to 11.6 mmol/L (p=0.001). When assessing the number of hypoglycemia episodes below 3.9 mmol/l, the frequency of this side effect was statistically significantly lower in group 1 (p<0.001). The results of the analysis of episodes of severe hypoglycemia showed a lower frequency in group 1 (p>0.05), but the results were not statistically significant. Subcutaneous insulin therapy: glucose levels in group 1 were statistically significantly more likely to be in the target range of 5.6–10.0 mmol/l (p=0.017) and in the range from 4.3 to 11.6 mmol/l (p = 0.017) compared to group 2. When assessing the number of episodes of hypoglycemia below 3.9 mmol/l, no statistically significant differences were found between groups (p<0.112). There were no episodes of severe hypoglycemia in both groups.
Conclusion. The results of our study demonstrate the safety of use of the CGM system in patients in the early postoperative period after TDPE.
Objective. Evaluation of the safety of using the Guardian Connect continuous glucose monitoring (CGM) system in the early postoperative period in patients after TDPE.
Methods. A retrospective assessment of glucose values recorded in the electronic medical record of 28 patients after TDPE who were followed-up in the clinic from 2020 to 2023 was carried out. In group 1, 13 patients were monitored for glycemic control using the Guardian Connect CGM system (in parallel with the use of a glucometer). In group 2, 15 patients underwent glycemic control only using a glucometer.
Results. Intravenous insulin therapy: glucose levels in group 1 were statistically significantly more likely to be in the target range of 5.6–10.0 mmol/L (p = 0.005) and in the range from 4.3 to 11.6 mmol/L (p=0.001). When assessing the number of hypoglycemia episodes below 3.9 mmol/l, the frequency of this side effect was statistically significantly lower in group 1 (p<0.001). The results of the analysis of episodes of severe hypoglycemia showed a lower frequency in group 1 (p>0.05), but the results were not statistically significant. Subcutaneous insulin therapy: glucose levels in group 1 were statistically significantly more likely to be in the target range of 5.6–10.0 mmol/l (p=0.017) and in the range from 4.3 to 11.6 mmol/l (p = 0.017) compared to group 2. When assessing the number of episodes of hypoglycemia below 3.9 mmol/l, no statistically significant differences were found between groups (p<0.112). There were no episodes of severe hypoglycemia in both groups.
Conclusion. The results of our study demonstrate the safety of use of the CGM system in patients in the early postoperative period after TDPE.
Keywords: total duodenopancreatectomy, target glycemic range, glycemic monitoring, pancreatic cancer, diabetes mellitus
About the Autors
Corresponding author: Aleksandr G. Farmanov, Endocrinologist, Graduate student of the Department of Endocrinology, Institute of Clinical Medicine No. 1 n.a. N.V. Sklifosovsky,I.M. Sechenov First Moscow State Medical University (Sechenov University); Ilyinskaya Hospital, Moscow region, Krasnogorsk, Russia; a.farmanov@ihospital.ru
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