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Factors Associated With Predialysis Plasma Glucose Variability in Patients With Diabetes on Hemodialysis
Cheng-Chieh Yen1,2, Chiung-Pei Huang3, Hung-Pin Tu4
1Department of Internal Medicine, Division of Nephrology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, cych.org.tw.
Introduction:
Patients with diabetes on hemodialysis (HD) have higher mortality and poorer health-related quality of life than those without diabetes. In this setting, glycated hemoglobin is of limited value, whereas glycemic variability (GV) may better guide diabetes management and therapeutic monitoring. We aimed to identify factors associated with GV among our cohort.
Methods:
We retrospectively collected patient characteristics, dialysis parameters, and laboratory data of patients with diabetes on HD in 2024. GV was assessed by coefficient of variation (Glucose_cv) and variability independent of the mean (Glucose_VIM), derived from monthly predialysis random plasma glucose measurements. Associations between variables and GV were analyzed using regression and correlation methods.
Results:
After adjustment for confounders, age remained significantly and inversely associated with both Glucose_cv (β < -0.01, p = 0.02) and Glucose_VIM (β < -0.01, p = 0.02). In age-stratified analyses, mean Glucose_cv differed significantly across quartiles (p < 0.01) and showed a significant decreasing trend (p < 0.01). Glucose_VIM likewise declined progressively across age quartiles with a confirmed downward trend (p < 0.01).
Conclusions:
Age showed an independent inverse relationship with GV in patients with diabetes on HD. These findings underscore the need for age-tailored glycemic strategies in this patient population and support further studies to determine their impact on clinical outcomes.
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