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Kidney Week

ASN / Education & Meetings / Kidney Week /
Abstract: TH-PO739

Diabetes Distress Is High and Negatively Affects Diabetes Control in Kidney Transplant Recipients (KTR): A Prospective Study

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Kukla, Aleksandra, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Sahi, Sukhdeep Singh, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Denic, Aleksandar, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kurek, Corey, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kaur, Ravinder Jeet, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Shaik, Afsana Ansari, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Smith, Byron H., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Diwan, Tayyab S., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Stegall, Mark D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kudva, Yogish C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

Impact of diabetes distress (DDS) on type 2 diabetes (T2D) control in KTR is unknown. Validated T2D DDS questionnaire includes emotional, physician-related, management related, and interpersonal distress components (17 points). Total scores>2 and ≥3 in each component indicate moderate and severe DDS, respectively.

Methods

We prospectively assessed DDS in 21 KTR at mean time of 2.1 (1.5) y post KT. Glucose control was assessed by Continuous glucose monitoring (CGM) metrics (Dexcom G6) worn for ten days and HbA1C.

Results

Table 1 depicts demographics and Figure 1 glucose metrics. Treatment regimens: Median DDS scores were 7 (IQR 5,13), 4 (IQR4,4), 8 (IQR 5,11), and 3 (IQR 3,5) for emotional, physician, treatment regimen, and interpersonal subscale, respectively. CGM metrics showed mean time in range (TIR; goal>70%) of 42.6 (25.2) %, and mean time in hyperglycemia of 57.4 (25.2) %. Treatment distress correlated with higher mean glucose (rs=0.44; p=0.04) and lower TIR (rs=-0.45; p=0.04) and higher HbA1c (latter in pts with no anemia) (rs=0.62; p=0.003). No correlation was found between HbA1c and CGM metrics.

Conclusion

KTR with T2D experience high DDS, which negatively impact glucose control. Efforts should be focused on reducing treatment burden.

Demographics
Mean age (yrs)61.7 (9.1)
BMI(Kg/m2)32.4 (3.9)
Mean glucose (mg/dL)*212 (64.4)
Hb (%)7.8 (1.4)
Normal Hb (N)16 (69.5%)
On Insulin (N)8 (34.7%)
On Insulin + other anti-hyperglycemic (N)13 (56.5%)
On non-insulin (N)2 (8.7%)

Funding

  • Commercial Support – DEXCOM