Glycemic pattern in diabetic patients on hemodialysis: continuous glucose monitoring (CGM) analysis
Massimo Gai1, Ilenia Merlo, Sergio Dellepiane
1SCU Nephrology, Dialysis and Transplantation, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Presidio 'Molinette', Torino, Italy.
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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