Real-Time Continuous Glucose Monitoring Among People With Type 2 Diabetes and End-Stage Kidney Failure Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial

IF 22.6 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Care Pub Date : 2026-06-26 DOI:10.2337/dc26-0404

Rodolfo J. Galindo, Bobak Moazzami, Amany Gerges, Ina Flores, Giuliana Arevalo, Limin Peng, Ian H. de Boer, Katherine R. Tuttle, Guillermo E. Umpierrez

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Abstract

OBJECTIVE There is a need for improved glycemia monitoring tools for people with type 2 diabetes (T2D) and end-stage kidney failure (ESKF). RESEARCH DESIGN AND METHODS This prospective, randomized, crossover trial compared the efficacy of real-time continuous glucose monitoring (rtCGM) with capillary blood glucose (CBG) testing in adults with T2D and ESKF undergoing hemodialysis. The primary outcome was percentage of time below range (%TBR) <70 mg/dL. RESULTS The %TBR <70 mg/dL was not significantly different between groups (mean 1.17% ± 1.8 vs. 1.29% ± 2.7; P = 0.28). Compared with CBG testing, percentage time in range (%TIR) was higher (63.4% ± 24 vs. 54.5% ± 23) and mean glucose lower (173.6 ± 37 vs. 187.7 ± 38 mg/dL) after the rtCGM intervention, while percentage time above range (%TAR) >180 mg/dL (35.3% ± 25 vs. 44.3% ± 23) and >250 mg/dL decreased (12.3% ± 15 vs. 18.8% ± 19) (all P ≤ 0.01). CONCLUSIONS In adults with T2D and ESKF undergoing hemodialysis, TBR was minimal and not influenced by rtCGM use. Compared with CBG testing, %TIR and %TAR improved during the rtCGM intervention. Future studies are needed to confirm the benefits of rtCGM in this population.

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进行维持性血液透析的2型糖尿病终末期肾衰竭患者的实时连续血糖监测：一项随机临床试验

针对2型糖尿病（T2D）和终末期肾衰竭（ESKF）患者，需要改进血糖监测工具。研究设计和方法：这项前瞻性、随机、交叉试验比较了实时连续血糖监测（rtCGM）与毛细血管血糖（CBG）检测在接受血液透析的成人T2D和ESKF患者中的疗效。主要终点是低于范围的时间百分比（%TBR） <；70 mg / dL。结果%TBR &；lt；70 mg/dL组间差异无统计学意义（平均1.17%±1.8 vs. 1.29%±2.7;P = 0.28）。与CBG测试相比，rtCGM干预后，在范围内的时间百分比（%TIR）更高（63.4%±24比54.5%±23），平均血糖更低（173.6±37比187.7±38 mg/dL），高于范围的时间百分比（%TAR） >；180 mg/dL(35.3%±25 vs. 44.3%±23)；250 mg/dL降低（12.3%±15 vs. 18.8%±19）（均P≤0.01）。结论：在接受血液透析的成人T2D和ESKF患者中，TBR很小，且不受rtCGM使用的影响。与CBG测试相比，rtCGM干预期间%TIR和%TAR均有所改善。需要进一步的研究来证实rtCGM在这一人群中的益处。

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来源期刊

Diabetes Care 医学-内分泌学与代谢

CiteScore

27.80

自引率

4.90%

发文量

449

审稿时长

1 months

期刊介绍： The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.