Figure legends
Figure 1. Distribution of patient glucose coefficient of variation (CV) values for time interval and grade. The pre-HSCT interval is shown in Panel A and the day 0-30 post-HSCT interval in Panel B. Glucose CVs are color-coded to demonstrate grades: Grade 1 <20% (green), approximating CV of healthy adults (Grade 1, <20%); Grade 2 ≥20-<27% (orange), approximating CV of adults who are obese or receive aggressive oral therapy for type 2 diabetes; Grade 3 ≥27- <36% (purple), approximating CV of adults with type 1 or 2 diabetes that is well-controlled with insulin; and Grade 4 ≥36% (pink), which has been defined as the cutoff for adults with poorly controlled type 1 diabetes. The distribution of patient glucose CVs demonstrates right skew and a marked number of patients with glucose CVs in the range of glucose CVs of adults who are obese or have diabetes.
Figure 2. Hazard ratios for all-cause mortality by glucosecoefficient of variation (CV) stratified by hematopoietic stem cell transplant (HSCT) type for the pre-HSCT (Panel A) and day 0-30 (Panel B) intervals; hazard ratios for transplant-related mortality (TRM) for the pre-HSCT (Panel C) and day 0-30 (Panel D) intervals.There was an interaction between glucose CV and HSCT type for risk of all-cause mortality models (p=0.079 pre-HSCT, p=0.02 post-HSCT); as such, Panels A and B are stratified by HSCT type. Among allogeneic HSCT patients and after adjusting for post-HSCT steroid therapy and diagnosis of severe graft versus host disease (GVHD), there was not a significant association between pre-HSCT glucose CV and risk of death (HR 1.40; 95% CI 0.98-1.99) (Panel A). In a similar analysis for day 0-30 glucose CV, there was an increase in risk of death with every doubling of day 0-30 glucose CV (HR 1.38; 95% CI 1.00-1.91) (Panel B). In contrast to risk of all-cause mortality, there was no interaction between glucose CV and HSCT type in TRM models. There was not a significant association between pre-HSCT (HR 1.42; 95% CI 0.92-2.19) or day 0-30 (HR 1.33; 95% CI 0.86-2.06) glucose CV and TRM, after adjusting for HSCT type, post-HSCT steroid therapy, and severe GVHD (Panels C-D).
Figure 3. Adjusted hazard ratio for time-to-infection (top figure) and adjusted odds of infection subtypes (bottom figure) for each doubling of pre-hematopoietic stem cell transplant (HSCT) glucose coefficient of variation (CV). There was a 4.91 (95% CI 1.4-17.24)-fold higher risk of infection with each doubling of pre-HSCT glucose CV, after adjusting for transplant type. Among allogeneic HSCT patients, there was a 1.77-fold (95% CI 1.23-2.56) increased odds of viremia/viruria post-HSCT with every doubling of pre-HSCT glucose CV. Odds of viremia was not assessed for autologous HSCT patients. Among all patients, adjusted for HSCT type, there was no increased odds of serious bacterial illness (SBI) or fungal infection with increasing pre-HSCT glucose CV.