A Comparison Study of Glucose Fluctuation During Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis.

In recent years, it has become possible to examine an individual's daily glucose profile with a continuous glucose monitoring system (CGMS). The aim of the present study was to use a CGMS to evaluate the difference in glucose fluctuation between diabetic patients on automated peritoneal dialysis (APD) and those on continuous ambulatory peritoneal dialysis (CAPD). We retrospectively studied 20 diabetic patients on peritoneal dialysis (16 men, 4 women; mean age: 55 ± 10 years) who used a CGMS a total of 23 times (12 times by APD users, 11 times by CAPD users). The difference in the maximum and minimum blood glucose over 72 hours (ABG) and the standard deviation of blood glucose were used as indicators of glucose fluctuation. Average blood glucose levels as evaluated by CGMS and by glycosylated hemoglobin were not significantly different between the APD and CAPD patients. However, the ABG (181 ± 64 mg/dL vs. 238 ± 67 mg/dL, p = 0.02) and the standard deviation of blood glucose (36.3 ± 14.5 mg/dL vs. 49.2 ± 14.1 mg/dL, p = 0.03) were significantly lower in the APD patients than in the CAPD patients. The present study indicates that, compared with CAPD, APD might reduce glucose fluctuation in diabetic peritoneal dialysis patients.