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Year : 2023  |  Volume : 2  |  Issue : 1  |  Page : 13-16

Ambulatory glucose profile of type 2 diabetes patients with end-stage renal disease undergoing hemodialysis: A pilot study

1 Department of Diabetes and Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India
2 Department of Medicine, D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India

Correspondence Address:
Ambika G Unnikrishnan
Department of Diabetes and Endocrinology, Chellaram Diabetes Institute, Pune - 411 021, Maharashtra
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Source of Support: The study was partially funded by Chellaram Foundation, Conflict of Interest: There are no conflicts of interest

DOI: 10.4103/cdrp.cdrp_CDRP_23_22

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Background: Management of glucose levels in patients with diabetes mellitus and end-stage renal disease (ESRD) is challenging. There are various factors contributing to glycemic variability (GV), including altered metabolism of glucose and insulin in the ESRD stage. Continuous glucose monitoring (CGM) system measures glucose levels continuously and helps to study the glucose profile of patients undergoing hemodialysis (HD). This pilot study aimed to analyze the ambulatory glucose profile (AGP) of type 2 diabetes patients with ESRD undergoing HD and study the GV when patients were on HD (referred to as ON days) versus when patients were not on HD (referred as OFF days). Materials and Methods: We enrolled 10 patients with type 2 diabetes mellitus and ESRD undergoing maintenance HD in the study. Data regarding patient characteristics, including age, gender, duration of diabetes mellitus, HbA1c, and serum fructosamine, were collected. The AGP data obtained by the CGM sensor on the HD ON days was compared to AGP data on HD OFF days. Results: There was a significant linear correlation of CGM-derived average blood glucose with HbA1c value; however, the association was not significant with fructosamine level. The CGM-derived average glucose level was significantly lower during HD ON days compared to HD OFF days, difference being 29.9 mg/dl (−33.7, −26.0; P < 0.001), whereas GV was significantly higher during HD OFF days compared to ON days. Conclusion: The variation in the glucose levels was higher during the HD OFF days compared to HD ON days. Future AGP studies recruiting more number of patients on HD will help better understand the clinical impact of glucose profile and GV in ESRD patients.

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