NDT Advance Access originally published online on April 23, 2009
Nephrology Dialysis Transplantation 2009 24(9):2866-2871; doi:10.1093/ndt/gfp181
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Glycaemic control in type 2 diabetic patients on chronic haemodialysis: use of a continuous glucose monitoring system
1 Centre Hospitalier Sud Francilien, Service de diabétologie, 91100 Corbeil-Essonnes 2 CHU Poitiers, Medecine Interne, Endocrinologie, Diabetologie, BP 577, 86021 Poitiers Cedex 3 Faculté de Médecine-Pharmacie, Rue de la Milétrie, 86000 Poitiers 4 Université de Poitiers, 15 Rue de l’Hôtel-Dieu, 86014 Poitiers 5 CHU Poitiers, Néphrologie et Transplantation Rénale, BP 577, 86021 Poitiers Cedex 6 Centre Hospitalier Sud Francilien, Service de Néphrologie, Rue Pont Amar 91080 Courcouronnes 7 CHU de Poitiers, INSERM CIC 802, Biostatistics, BP 577, 86021 Poitiers Cedex 8 INSERM U 927, BP 577, 86021 Poitiers Cedex, France
Correspondence and offprint requests to: Samy Hadjadj; E-mail: s.hadjadj{at}chu-poitiers.fr
 |
Abstract |
|---|
Background. The proportion of diabetic patients undergoing haemodialysis is rapidly increasing. Glucose control among such patients is difficult to assess. We aimed to evaluate the clinical performance of a continuous glucose monitoring system (CGMS) in type 2 diabetic patients on chronic haemodialysis.
Methods. We used a 4-day CGMS to monitor glucose levels in 19 haemodialysed type 2 diabetic patients (HD T2) including 2 days with and 2 days without dialysis session, and 39 non-HD T2 in a double-centre study.
Results. The glucose concentration according to the glucose meter and CGMS were correlated in HD T2 patients (r = 0.90, P < 0.0001) and in non-HD T2 patients (r = 0.81, P < 0.0001). The relative absolute difference (RAD) between glucose determined by a glucose meter and glucose determined by the CGMS did not differ between HD T2 and non-HD T2 patients (9.2 ± 10.5 vs. 8.2 ± 7.6%; P = 0.165). Glycated haemoglobin (A1c) and mean glucose concentration were strongly correlated in non-HD T2 patients (r = 0.71; P < 0.0001) but weakly correlated in HD T2 patients (r = 0.47; P = 0.042). Fructosamine was correlated with the mean glucose concentration in non-HD T2 (r = 0.67; P < 0.0001) but not in HD T2 patients (r = 0.04; P = 0.88).
Conclusion. CGM is a validated marker of glycaemic control in HD diabetic patients. This tool showed that A1c and fructosamine, despite being good markers of glycaemic control in non-HD diabetic patients, are of poor value in HD diabetic patients.
Keywords: CGMS; diabetes; dialysis; end-stage renal failure; haemodialysis
* Both authors contributed equally to this work.
Received for publication: 14. 1.09
Accepted in revised form: 30. 3.09
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J.-P. Riveline and S. Hadjadj Assessing Glycemic Control in Maintenance Hemodialysis Patients With Type 2 Diabetes: Response to Kazempour-Ardebili et al. Diabetes Care, December 1, 2009; 32(12): e155 - e155. [Full Text] [PDF]
|
|
|
|
|
|
S. Kazempour-Ardebili, V. L. Lecamwasam, T. Dassanyake, A. H. Frankel, F. W.K. Tam, A. Dornhorst, G. Frost, and J. J.O. Turner Assessing Glycemic Control in Maintenance Hemodialysis Patients With Type 2 Diabetes: Response to Riveline and Hadjadj Diabetes Care, December 1, 2009; 32(12): e156 - e156. [Full Text] [PDF]
|
|