Diabetes MellitusNCT05352230
Continuous Glucose Monitoring (CGM) in Kidney-Transplanted Adults
A study testing Free style libre-2 in people with Diabetes Mellitus and Kidney Transplant; Complications, run by University of Alabama at Birmingham at 1 site in United States.
Trial summary
Pre-existing diabetes prior KT and Early Post-Transplant Hyperglycemia (PTRH) defined as a fasting blood glucose greater than or equal to 126 mg/dL or random glucose greater than or equal to 200 mg/dL or requirement of insulin during the first 45 days after KT has been associated with increased risks of… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Diabetes Mellitus, Kidney Transplant; Complications
- What is being tested?
- Free style libre-2
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 4 participants
- Where
- 1 siteUnited States
- Study dates
- 15 Apr 2023to 20 May 2024
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- patients older than 18 years
- patients with history of diabetes (either T1D, T2D or atypical diabetes forms)
- patients could be on insulin or not before transplantation
Who cannot join
- kidney-pancreas transplanted participants
- not currently using CGM (but could have used a year prior the transplant)
- mental conditions that prevent continuing with the study.
Trial locations and contacts
1 site in 1 country.
About this study
Pre-existing diabetes prior KT and Early Post-Transplant Hyperglycemia (PTRH) defined as a fasting blood glucose greater than or equal to 126 mg/dL or random glucose greater than or equal to 200 mg/dL or requirement of insulin during the first 45 days after KT has been associated with increased risks of post-transplant organ rejection. PTRH has also been associated to high infection rates, and in some cases, early mortality. The use of continuous glucose monitoring (CGM) compared with blood glucose meter monitoring in non-transplant patients with diabetes resulted in lower HbA1C by 0.4 to 0.5% within the first three months of use without major changes in patients' antidiabetic regimen, possibly due to patients become more conscious about their diabetes status and diet. CGM free style libre-2 measures the interstitial fluid every minute and their glucose sensors are replaced every two weeks. To our knowledge there are no studies that assess the role of CGM in improving glycemic and transplant outcomes in solid organ transplant patients, mainly because access to CGM is often limited by inadequate health insurance coverage or high out-of-pocket costs.
The investigators hypothesize that the intervention will be feasible and acceptable to patients, and our overarching hypothesis is that patients who wear a CGM will have better glycemic control, using a proxy measure of lower fructosamine/albumin ratio and better CGM-parameters, compared to those who did not wear it. Fructosamine represents the average glycemia for the 2 to 3 weeks prior. It is useful in any situation where glycemic control needs to be assessed over a period shorter than a month and in cases involving interference in the HbA1C measurement such as in adults with KT due to shorter red blood cell lifespan related to anemia of chronic disease. Fructosamine values vary in relation to the serum albumin concentration, which makes the fructosamine/albumin ratio the ideal physiologic measure for this pilot study . The investigators also hypothesize that patients who wear a CGM will have less microalbuminuria compared to those who did not wear it.
Read the detailed description
Diabetes is a leading cause of end-stage renal disease, which is treated by undergoing kidney transplantation. Glycemic control post-transplantation is complicated for the diabetic population by a complicated medication regimen that suppresses immunologically-driven graft loss but increases glucose levels. Hyperglycemia in this transplant population results in transplant failure. Improving glycemic control in the diabetic kidney transplant population may decrease kidney transplantation failure rates. Continuous glucose monitors have been shown to improve glycemic control among insulin-dependent diabetics. Therefore, the investigators aim to assess the feasibility and acceptance of continuous glucose monitoring among diabetic kidney transplant patients.
This is an open-label, randomized, crossover design study comparing diabetic, kidney-transplant recipients managing their diabetes with a continuous glucose monitor or glucometer. Eligible participants will engage study staff during regularly scheduled, standard of care, post-operative visits. Utilization of the CGM will be assess to determine the feasibility of CGM usage in this population. Participants will complete validated quality-of-life surveys (Diabetes Treatment Satisfaction Questionnaire (DSTQ) and Hypoglycemic Confidence Scale (HSC)) throughout the 32 weeks study regimen to inform the acceptability of CGM usage. Glucose records, provided by glucose meters and CGMs that report glucose readings to either the participant or clinic will be leveraged to estimate if CGM usage decreases hyperglycemia among diabetic kidney-transplant recipients.
Results from this study will be foundational towards assessing if CGM usage improves glycemic control among diabetic kidney-transplant recipients, improves transplant outcomes and, hopefully, triggering health insurance providers to reassess the return on investment of subsidizing continuous glucose monitoring in the kidney-transplant population.
- Being tested
- Free style libre-2
- Medical subject headings
- Diabetes Mellitus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Free style libre-2Device
A cross-over design will allow estimation of feasibility and acceptability of patients using CGM vs patients using blood glucose meter monitoring (conventional therapy). The study will consist on two phases, the first will last three months, then it will be a two months of washout period followed by the crossover, then the second phase will last another three months. Patients in the conventional therapy group will also use masked CGM (CGM professional) during the first two and last two weeks of their study phase with the purpose of collecting CGM-parameters information. The cross over randomization will be stratified by donor type (live vs deceased) using a web-based randomization tool. During the washout period the patients will continue using blood glucose meter monitoring
| Study group | Role | What they receive |
|---|---|---|
| Continue Glucose Monitoring (CGM) | Active comparator | External diabetes device glucose sensor that measures interstitial glucose levels every minute Receives: Device: Free style libre-2 |
| Glucometer | Other | Device that measures capillary blood glucose levels Receives: Device: Free style libre-2 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Compliance
To determine the feasibility and acceptance of CGM in adults with diabetes who underwent kidney transplantation compared to those who use glucometers.
Measured: 32 weeks
Secondary outcomes (8)
Fructosamine/Albumin Ratio
glycemic marker
Measured: 20 weeks
Fructosamine/Albumin Ratio
glycemic marker
Measured: 32 weeks
Microalbuminuria
kidney function marker
Measured: 20 weeks
Microalbuminuria
kidney function marker
Measured: 32 weeks
Glucose Management Indicator (GMI)
glycemic marker
Measured: 20 weeks
Glucose Management Indicator (GMI)
glycemic marker
Measured: 32 weeks
Time in Range (TIR) of 70 to 180 mg/dL
glycemic marker
Measured: 20 weeks
Time in Range (TIR) of 70 to 180 mg/dL
glycemic marker
Measured: 32 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Apr 2022
- Study start15 Apr 2023
- Primary completion20 May 2024
- Study completion20 May 2024
Why it stopped: cessation of funds for study activities
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Diabetes MellitusStudies of the same condition, open and under way.
- More trials run by University of Alabama at BirminghamThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Enrolment
- 4 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Alabama at Birmingham
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Orlando M. Gutierrez, MD, MMSc, University of Alabama at Birmingham
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05352230
- Sponsor's protocol ID
- IRB-300009227
- Status last verified
- Jul 2025
- First submitted
- 20 Apr 2022
- Last updated
- 1 Aug 2025
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 1 Aug 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Continuous Glucose Monitoring (CGM) in Kidney-Transplanted Adults
- ClinicalTrials.gov ID
- NCT05352230
- Acronym / sponsor ID
- IRB-300009227
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: cessation of funds for study activities
- Enrolment
- 4 participants (actual)
- Lead sponsor
- University of Alabama at BirminghamUniversity, hospital or other
- Study start
- 15 Apr 2023 (actual)
- Primary completion
- 20 May 2024 (actual)
- Study completion
- 20 May 2024 (actual)
- First posted
- 28 Apr 2022 (actual)
- Results
- Posted 1 Aug 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Pre-existing diabetes prior KT and Early Post-Transplant Hyperglycemia (PTRH) defined as a fasting blood glucose greater than or equal to 126 mg/dL or random glucose greater than or equal to 200 mg/dL or requirement of insulin during the first 45 days after KT has been associated with increased risks of post-transplant organ rejection. PTRH has also been associated to high infection rates, and in some cases, early mortality. The use of continuous glucose monitoring (CGM) compared with blood glucose meter monitoring in non-transplant patients with diabetes resulted in lower HbA1C by 0.4 to 0.5% within the first three months of use without major changes in patients' antidiabetic regimen, possibly due to patients become more conscious about their diabetes status and diet. CGM free style libre-2 measures the interstitial fluid every minute and their glucose sensors are replaced every two weeks. To our knowledge there are no studies that assess the role of CGM in improving glycemic and transplant outcomes in solid organ transplant patients, mainly because access to CGM is often limited by inadequate health insurance coverage or high out-of-pocket costs.
The investigators hypothesize that the intervention will be feasible and acceptable to patients, and our overarching hypothesis is that patients who wear a CGM will have better glycemic control, using a proxy measure of lower fructosamine/albumin ratio and better CGM-parameters, compared to those who did not wear it. Fructosamine represents the average glycemia for the 2 to 3 weeks prior. It is useful in any situation where glycemic control needs to be assessed over a period shorter than a month and in cases involving interference in the HbA1C measurement such as in adults with KT due to shorter red blood cell lifespan related to anemia of chronic disease. Fructosamine values vary in relation to the serum albumin concentration, which makes the fructosamine/albumin ratio the ideal physiologic measure for this pilot study . The investigators also hypothesize that patients who wear a CGM will have less microalbuminuria compared to those who did not wear it.
Detailed description
Diabetes is a leading cause of end-stage renal disease, which is treated by undergoing kidney transplantation. Glycemic control post-transplantation is complicated for the diabetic population by a complicated medication regimen that suppresses immunologically-driven graft loss but increases glucose levels. Hyperglycemia in this transplant population results in transplant failure. Improving glycemic control in the diabetic kidney transplant population may decrease kidney transplantation failure rates. Continuous glucose monitors have been shown to improve glycemic control among insulin-dependent diabetics. Therefore, the investigators aim to assess the feasibility and acceptance of continuous glucose monitoring among diabetic kidney transplant patients.
This is an open-label, randomized, crossover design study comparing diabetic, kidney-transplant recipients managing their diabetes with a continuous glucose monitor or glucometer. Eligible participants will engage study staff during regularly scheduled, standard of care, post-operative visits. Utilization of the CGM will be assess to determine the feasibility of CGM usage in this population. Participants will complete validated quality-of-life surveys (Diabetes Treatment Satisfaction Questionnaire (DSTQ) and Hypoglycemic Confidence Scale (HSC)) throughout the 32 weeks study regimen to inform the acceptability of CGM usage. Glucose records, provided by glucose meters and CGMs that report glucose readings to either the participant or clinic will be leveraged to estimate if CGM usage decreases hyperglycemia among diabetic kidney-transplant recipients.
Results from this study will be foundational towards assessing if CGM usage improves glycemic control among diabetic kidney-transplant recipients, improves transplant outcomes and, hopefully, triggering health insurance providers to reassess the return on investment of subsidizing continuous glucose monitoring in the kidney-transplant population.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Continue Glucose Monitoring (CGM) | Active comparator | Device: Free style libre-2External diabetes device glucose sensor that measures interstitial glucose levels every minute |
| Glucometer | Other | Device: Free style libre-2Device that measures capillary blood glucose levels |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- patients older than 18 years
- patients with history of diabetes (either T1D, T2D or atypical diabetes forms)
- patients could be on insulin or not before transplantation
Key exclusion criteria (3 listed)
- kidney-pancreas transplanted participants
- not currently using CGM (but could have used a year prior the transplant)
- mental conditions that prevent continuing with the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Free style libre-2A cross-over design will allow estimation of feasibility and acceptability of patients using CGM vs patients using blood glucose meter monitoring (conventional therapy). The study will consist on two phases, the first will last three months, then it will be a two months of washout period followed by the crossover, then the second phase will last another three months. Patients in the conventional therapy group will also use masked CGM (CGM professional) during the first two and last two weeks of their study phase with the purpose of collecting CGM-parameters information. The cross over randomization will be stratified by donor type (live vs deceased) using a web-based randomization tool. During the washout period the patients will continue using blood glucose meter monitoring | Device | Continue Glucose Monitoring (CGM), Glucometer |
Primary outcome
Compliance
Time frame: 32 weeks
To determine the feasibility and acceptance of CGM in adults with diabetes who underwent kidney transplantation compared to those who use glucometers.
8 secondary outcomes
Fructosamine/Albumin Ratio
Time frame: 20 weeks
Fructosamine/Albumin Ratio
Time frame: 32 weeks
Microalbuminuria
Time frame: 20 weeks
Microalbuminuria
Time frame: 32 weeks
Glucose Management Indicator (GMI)
Time frame: 20 weeks
Glucose Management Indicator (GMI)
Time frame: 32 weeks
Time in Range (TIR) of 70 to 180 mg/dL
Time frame: 20 weeks
Time in Range (TIR) of 70 to 180 mg/dL
Time frame: 32 weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Aug 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Free style libre-2 in people with Diabetes Mellitus and Kidney Transplant; Complications, run by University of Alabama at Birmingham at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 1 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 1 Aug 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Compliance (time frame: 32 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Aug 2025.