Glycemic Pattern in Diabetic Patients on Hemodialysis: Continuous Glucose Monitoring (CGM) Analysis

• Published in: Blood purification Vol. 38; no. 1; pp. 68 - 73
• Main Authors: Gai, Massimo, Merlo, Ilenia, Dellepiane, Sergio, Cantaluppi, Vincenzo, Leonardi, Gianluca, Fop, Fabrizio, Guarena, Cesare, Grassi, Giorgio, Biancone, Luigi
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2014
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Diabetes Complications; Diabetes Mellitus - metabolism; Diabetes Mellitus - pathology; Diabetes Mellitus - therapy; Emergency and intensive care: renal failure. Dialysis management; Extracellular Fluid - chemistry; Female; Glucose - metabolism; Glycated Hemoglobin A - metabolism; Glycemic Index; Humans; Intensive care medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - metabolism; Kidney Failure, Chronic - pathology; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; Monitoring, Physiologic; Original Paper; Renal Dialysis; Diabetic nephropathy; Diabetes; Glucose; Glycemic variability; Hemodialysis; Continuous glucose monitoring system; Endocrinopathy; Kidney disease; Human; Urinary system disease; Diabetes mellitus; Variability; Nephropathy; Continuous Glucose Monitoring System
• ISSN: 0253-5068; 1421-9735
• DOI: 10.1159/000362863

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.