"Usefulness of continuous interstitial glucose in diabetic patient undergoing hemodialysis

IF 5.8 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2026-01-01 Epub Date: 2025-12-04 DOI:10.1016/j.diabet.2025.101720

Elise Berchoux , Ilan Szwarc , Jean-Baptiste Bonnet , Joanna Pissarra , Antoine Avignon , Sébastien Jugant , Moglie Le Quintrec , Ariane Sultan

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引用次数: 0

Abstract

Backgroung

In patients with type 2 diabetes (T2D) undergoing hemodialysis (HD), glycemic control is challenging, and glycated hemoglobin (HbA1c) is often unreliable due to altered red blood cell turnover, anemia, and treatments such as erythropoiesis-stimulating agents. Continuous glucose monitoring (CGM) provides additional metrics—such as time in range (TIR), time below range (TBR), and glycemic variability—that may better reflect glucose control in this population. This study aimed to assess the usefulness of 14-day CGM data compared to HbA1c in evaluating glycemic control in T2D patients on HD.

Methods

This is a prospective and multicenter study. Patients included were of > 18 years, DM2, and hemodialysis patients. We assessed glycemic control of diabetic hemodialysis patient over 14 days with the CGM freestyle 1 comparing to HbA1c.

Results

Forty-one patients were included. While 68 % had HbA1c < 8 %, only 21 % met the CGM targets (P < 0.005). Mean glucose levels were significantly lower on dialysis days (−13 mg/dl, P < 0.0001), without an increase in hypoglycemic episodes. Discrepancies between HbA1c and CGM metrics were associated with diabetes-related nephropathy and longer duration of HD.

Conclusion

HbA1c alone may substantially underestimate glycemic burden in patients on hemodialysis. CGM provides a more accurate assessment of glucose control and reveals undetected hypo- and hyperglucose levels. Incorporating CGM into routine care may improve diabetes management and therapeutic decision-making in this high-risk population.

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持续间质葡萄糖在糖尿病血液透析患者中的应用。

背景：在接受血液透析（HD）的2型糖尿病（T2D）患者中，血糖控制具有挑战性，糖化血红蛋白（HbA1c）通常不可靠，原因是红细胞周转改变、贫血和使用促红细胞生成药物等治疗。连续血糖监测（CGM）提供了额外的指标，如范围内时间（TIR）、范围下时间（TBR）和血糖变异性，可以更好地反映这一人群的血糖控制情况。本研究旨在评估14天CGM数据与HbA1c在评估糖尿病合并糖尿病患者血糖控制方面的有用性。方法：这是一项前瞻性多中心研究。纳入的患者包括18岁以下、DM2和血液透析患者。我们用CGM自由式1与HbA1c比较，评估糖尿病血液透析患者14天的血糖控制情况。结果：纳入41例患者。68%的患者HbA1c < 8%，只有21%的患者达到CGM目标（P < 0.005）。透析日的平均血糖水平显著降低（-13 mg/dl, P < 0.0001），低血糖发作没有增加。HbA1c和CGM指标之间的差异与糖尿病相关性肾病和更长的HD持续时间有关。结论：单独的HbA1c可能大大低估了血液透析患者的血糖负担。CGM提供更准确的血糖控制评估，揭示未检测到的低血糖和高血糖水平。将CGM纳入常规护理可改善这一高危人群的糖尿病管理和治疗决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.