1773-P: Early Glycemic Changes following Initiation of Glucocorticoid Therapy in Normoglycemic Kidney Transplant Recipients

Introduction and Objective: Glucocorticoid (GC) therapy is commonly associated with metabolic complications, particularly steroid-induced hyperglycaemia (SIH). The study aimed at characterizing early glycemic changes following GC therapy initiation in order to assess the optimal timing of antihyperglycemic treatment. Methods: Normoglycaemic adult patients after kidney transplantation were monitored using continuous glucose monitoring (CGM) since the first day of GC therapy. SIH was defined as ≥2 glucose readings ≥200 mg/dL. CGM data from the first three days were analysed and mean glucose values were compared using repeated-measures ANOVA (RM ANOVA). Results: Twelve patients (mean [±SD] age 48.6±10.9 years, BMI 25.6±4.5 kg/m², HbA1c 5.3±0.4%). The median daily steroid dose was equivalent to 102 mg of prednisone (1.5 mg/kg). SIH occurred in 8 patients, including 6 cases on the first day. No significant differences in mean glucose were observed across the first three days (F(2,22)=1.78; p=0.193). Nocturnal glucose values progressively normalised, while the daytime peaks persisted (Fig.1), gradually leading to increased glucose variability (from 23.6% on 1st day to 27.0% on 3rd day). Conclusion: GC therapy affects glycemia from the first day in most normoglycemic patients and progressively increases glucose variability, suggesting a need for early antihyperglycemic intervention. Disclosure A.S. Jedrasek: None. W. Ulicka: None. M. Macech: None. E. Wojtaszek: None. J. Malyszko: None. Z. Galazka: None. L. Czupryniak: Speaker's Bureau; Current; Abbott. Advisory Panel; Current; Abbott. Research Support; Current; Abbott.