Glucose variability in maintenance hemodialysis patients with type 2 diabetes: Comparison of dialysis and nondialysis days

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Introduction: Hemodialysis (HD) induces several physiological changes that can affect plasma glucose levels in patients with diabetes and in turn their glycemic control. Studies using continuous glucose monitoring (CGM) to assess glucose variations on dialysis days compared with nondialysis days report conflicting results. Here, we used CGM to examine glucose variations induced by HD in patients with type 2 diabetes. Methods: Patients with type 2 diabetes undergoing maintenance HD were included. CGM (Ipro2®, Medtronic) was performed at baseline and Week 4, 8, 12, and 16 for up to 7 days at each visit. CGM profiles on days where participants received HD were compared with days without HD using a linear mixed model. Findings: Twenty-seven patients were included. The median number of CGM days performed was 8 (interquartile range [IQR] 6–10) for dialysis days and 16 (IQR 12–17) for nondialysis days. The median sensor glucose was 9.4 (95% confidence interval [CI] 8.8–10.2) mmol/L on dialysis days compared with 9.5 (95% CI 8.9–10.2) mmol/L on nondialysis days (p = 0.58). Nocturnal mean sensor glucose was higher on dialysis days compared with nondialysis days: 8.8 (95% CI 8.0–9.6) mmol/L versus 8.4 (95% CI 7.7–9.2) mmol/L (p = 0.029). Discussion: Similar median sensor glucose values were found for days on and off HD. Nocturnal glucose levels were modestly increased on dialysis days. Our findings indicate that antidiabetic treatment does not need to be differentiated on dialysis versus nondialysis days in patients with type 2 diabetes undergoing maintenance HD.

OriginalsprogEngelsk
TidsskriftHemodialysis International
Vol/bind27
Udgave nummer2
Sider (fra-til)126-133
Antal sider8
ISSN1492-7535
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This work was supported by Rigshospitalet's research grant (December 2017), Helen og Ejnar Bjørnows foundation (December 2017).

Funding Information:
Dr. Knop reports grants, personal fees and nonfinancial support from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Carmot Therapeutics, personal fees and nonfinancial support from Eli Lilly, grants from Gubra, personal fees from MedImmune, personal fees and nonfinancial support from MSD/Merck, personal fees from Norgine, grants, personal fees and nonfinancial support from Novo Nordisk, grants and personal fees from Sanofi, grants and personal fees from Zealand Pharma, personal fees from Bayer outside the submitted work. Dr. Heinrich reports stocks in Novo Nordisk A/S and Akcea Therapeutics Inc.

Publisher Copyright:
© 2023 The Authors. Hemodialysis International published by Wiley Periodicals LLC on behalf of International Society for Hemodialysis.

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