Clinical associations of glycemic control in diabetics on CAPD

Diabetic control in 110 diabetics (39 type I and 71 type II), who had been on continuous ambulatory peritoneal dialysis (CAPD) for at least 3 months, was considered good (group G, n = 63) or poor (group P, n = 47) if > 50% or < or = 50% of glucose measurements, respectively, were within 3.3-11.1 mmol/L. Compared to group P, group G had more type I diabetics and fewer type II diabetics; higher serum cholesterol and lower serum creatinine; higher rates of blindness, autonomic neuropathy, congestive heart failure, myocardial infarction, cerebrovascular accidents and extremity gangrene; higher annual rates of peritonitis (1.47 +/- 1.31 vs 0.98 +/- 1.19 episodes/patient-year), exit-site/tunnel infection (0.83 +/- 1.14 vs 0.39 +/- 0.68 episodes/patient-year), and catheter loss (0.81 +/- 0.59 vs 0.39 +/- 0.52 episodes/patient-year); and longer hospitalization (38 +/- 31 vs 14 +/- 15 days yearly). All differences were significant at p = 0.05 or lower. According to life-table analysis, median patient survival was 25 +/- 3 months in group P and 85 +/- 17 months in group G (p < 0.0001). Technique survival was 14 +/- 2 months for group P and 28 +/- 4 months for group G (p < 0.0001). Good diabetic control in diabetics on CAPD is associated with better outcome and constitutes, therefore, a desirable therapeutic goal.