*Purpose: Continuous glucose monitoring (CGM) provides a 24-hour view of glucose values and information on glycemic variability and additional indices such as the glucose management indicator (GMI), which is an estimated A1C derived from the glucose measures. The purpose of this study was to observe the changes in glucose patterns from pretransplant to posttransplant period and analyze the efficacy and safety of continuous glucose monitoring in transplant patients.

*Methods: Patients planned to undergo kidney transplantation operations were enrolled in a prospective observational study starting May 1st, 2021. Upon enrollment, a CGM system was applied at least 2 weeks prior to admission for transplant operation for the preoperative CGM. Postoperative CGM was applied to the same patients on the day of admission for the transplant operation, which was 2 days before the operation. CGM was scheduled for 2 weeks preoperatively and postoperatively each. No additional interventions were undertaken.

*Results: By November 1, 2021, preoperative and postoperative CGM was performed in 25 living donor kidney transplantation recipients. Five patients received allografts from ABO incompatible donors and received preoperative desensitization. The preoperative CGM in these patients was completed before the sensitization protocol was performed. 6 patients had underlying type 2 diabetes. Postoperative mean glucose level was significantly higher than the preoperative mean glucose level (124.1±27.9 vs. 102.1±34.3 mg/dL, respectively; p=<0.001). The average daily time percentage in the glucose range from 181-250mg/dL was higher in the postoperative period than the preoperative period (12.1±11.3 vs. 8.6±15.5%, respectively; p=0.016). In contrast, the daily time percentage in the glucose range <70mg/dL was higher in the preoperative period than in the postoperative period (16.2±17.0 vs. 8.0±8%, respectively; p=0.021). The average glucose variability was not significantly different between the preoperative and postoperative period (30.0±8.5 vs. 34.2±10.5%, respectively; p=0.080). However, the average (GMI) was higher in the postoperative period than the postoperative period (6.9±3.2 vs. 5.60±0.8% respectively; p=0.001).

*Conclusions: The continuous glucose monitoring of kidney transplantation recipients showed that the postoperative period had a higher mean glucose level and mean time spent in the glucose range of 181-250mg/dL. Patients had significantly more hypoglycemic (<70mg/dL) incidences in the preoperative period.

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