Abstract
We sought to investigate the impact of dialysis on glucose profiles of diabetic patients
using continuous glucose monitoring (CGM). The study included 33 hemodialyzed patients
with diabetes (14 females and 19 males; mean age: 66±8 years; patients with type 2
diabetes: 30; mean duration of dialysis: 3.8±2.6 years) who were under insulin treatment.
After a run-in period, CGM was performed for 48 h, including a dialysis session. Three
CGM sessions were proposed for each patient over a 3-month period. CGM results were
analyzed during and after dialysis at 6 different time points. Moreover, data were
analyzed in 7 different day periods according to meals. Of the 99 CGM available, 21
were excluded because of technical issues or patient refusal. The CGM results indicated
that mean glucose values (7.5±2.5 mmol/l vs. 9.4±1.9 mmol/l; p<0.001) and variability
indices (p<0.001) were lower, whereas the frequency of hypoglycemia (4.4±9.6% vs.
2.1±7.9%; p<0.001) was higher during hemodialysis sessions. Significant differences
were observed in glucose values only before and 2 h after breakfast (p<0.001). Compared
with other day periods, glucose values were lower during the second half of the night
and higher before and after dinner (p<0.001). In summary, CGM allows the identification
of a particular glucose profile in hemodialyzed diabetic patients. CGM seems feasible
and clinically useful for the analysis of glucose profiles in this group of patients.
Key words
diabetes - hemodialysis - continuous glucose monitoring
