Glycemic pattern in diabetic patients on hemodialysis: continuous glucose monitoring (CGM) analysis.

Blood Purif

SCU Nephrology, Dialysis and Transplantation, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Presidio 'Molinette', Torino, Italy.

Published: July 2015


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Article Abstract

Background/aims: Recent evidences suggest that hemodialysis (HD) induces glycemic variations in diabetic patients. Continuous glucose monitoring (CGM) devices measure interstitial glucose in a 'Holter-like' manner thereby improving the glycemic control assessment method.

Methods: A CGM device (Medtronic iPRO) was used on 12 diabetic patients with chronic HD for 6 days to assess intra- and extra-dialytic interstitial glucose.

Results: In all enrolled patients, HD was associated with a decrease of interstitial glucose values. Intradialytic glucose nadir was 79 mg/dl and it was reached at the third hour after the beginning of the session. At the end of HD, interstitial glucose increased in all patients and a glycemic peak (187 mg/dl) occurred after an average time of 2.5 h. No episodes of nocturnal hypoglycemia occurred.

Conclusion: HD is associated with significant intradialytic reduction of glycemia and postdialytic hyperglycemia. CGM devices result in better monitoring of glycemic trends in diabetic patients on chronic HD and could improve insulin management.

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http://dx.doi.org/10.1159/000362863DOI Listing

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