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Glycemic Patterns Revealed by Continuous Glucose Monitoring in Patients with Type 2 Diabetes Undergoing Intermittent

Miguel Angel Cuevas-Budhart1, Joel Salvador Becerra-Barrera2, Rogelio Iván Silva-Rueda2

  • 1Unidad de Investigación Médica en Enfermedades Nefrológicas del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico.

Medical Sciences (Basel, Switzerland)
|June 25, 2026
PubMed

Insights

Continuous glucose monitoring (CGM) in type 2 diabetes mellitus patients on hemodialysis reveals significant glycemic variability and intradialytic changes missed by HbA1c. CGM offers valuable insights into metabolic dysregulation during dialysis.

Area of Science:

  • Nephrology
  • Endocrinology
  • Diabetes Mellitus Research

Background:

  • Glycemic control is challenging in type 2 diabetes mellitus patients undergoing hemodialysis due to CKD and dialysis effects.
  • Traditional metrics like HbA1c may not fully capture glycemic fluctuations in this population.
  • Continuous glucose monitoring (CGM) offers dynamic assessment of glucose profiles.

Purpose of the Study:

  • To evaluate the utility of CGM in assessing glycemic control in patients with type 2 diabetes mellitus on intermittent hemodialysis.
  • To identify glycemic patterns and dysregulation not detected by standard clinical practice.

Main Methods:

  • Observational, cross-sectional pilot study with 10 hemodialysis patients.
  • 14-day CGM monitoring.
  • Paired analysis comparing glycemic parameters on hemodialysis versus non-hemodialysis days.

Main Results:

  • High interindividual variability in Time in Range (TIR), predominantly hyperglycemia.
  • Significant intradialytic glucose decline followed by incomplete recovery during hemodialysis (p < 0.001).
  • Hypoglycemia was infrequent; persistent hyperglycemia was prevalent.

Conclusions:

  • CGM highlights metabolic dysregulation often missed by HbA1c in hemodialysis patients.
  • CGM may provide clinically relevant glycemic information in this population.
  • Larger studies are required to establish therapeutic recommendations.

Keywords:
continuous glucose monitoringdiabetes mellitus type 2glycemic variabilityhemodialysistime in range

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