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

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-02-09 DOI:10.1111/hdi.13073

Tobias Bomholt, Marianne Rix, Thomas Almdal, Filip K. Knop, Susanne Rosthøj, Morten B. Jørgensen, Bo Feldt-Rasmussen, Mads Hornum

{"title":"Glucose variability in maintenance hemodialysis patients with type 2 diabetes: Comparison of dialysis and nondialysis days","authors":"Tobias Bomholt, Marianne Rix, Thomas Almdal, Filip K. Knop, Susanne Rosthøj, Morten B. Jørgensen, Bo Feldt-Rasmussen, Mads Hornum","doi":"10.1111/hdi.13073","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>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 (<i>p</i> = 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 (<i>p</i> = 0.029).</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hdi.13073","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hdi.13073","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 2

Abstract

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.

Abstract Image

查看原文本刊更多论文

2型糖尿病维持性血液透析患者的血糖变异性：透析和非透析天数的比较。

引言：血液透析（HD）会引起一些生理变化，这些变化会影响糖尿病患者的血糖水平，进而影响他们的血糖控制。使用连续血糖监测（CGM）评估透析日与非透析日血糖变化的研究报告了相互矛盾的结果。在这里，我们使用CGM来检测HD在2型糖尿病患者中诱导的葡萄糖变化。方法：纳入接受维持性HD的2型糖尿病患者。CGM（Ipro2®，美敦力）在基线和第4、8、12和16周进行，持续时间长达7周天。使用线性混合模型将参与者接受HD的天数的CGM概况与未接受HD的日子进行比较。研究结果：包括27名患者。透析天数的中位CGM天数为8天（四分位间距[IQR]6-10），非透析天数为16天（IQR 12-17）。透析日的中位传感器葡萄糖为9.4（95%置信区间[CI]8.8-10.2）mmol/L，而非透析日为9.5（95%可信区间8.9-10.2）mol/L（p=0.58）。透析日的夜间平均传感器葡萄糖高于非透析日：8.8（95%CI 8.0-9.6）mmol/L与8.4（95%CI 7.7-9.2）mmol/L（p=0.029）在HD上下发现了好几天。透析日夜间血糖水平适度升高。我们的研究结果表明，在接受维持性HD的2型糖尿病患者中，抗糖尿病治疗不需要在透析和非透析日进行区分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.