INTRODUCTION: Glycated hemoglobin is used to assess diabetic control although its accuracy in dialysis has been questioned. How does it compare to the Continuous Glucose Monitoring System (CGMS) in peritoneal dialysis (PD) patients? METHODS: We conducted a retrospective analysis of 60 insulin-treated diabetic patients on PD. We determined the mean interstitial glucose concentration and the proportion of patients with hypoglycemia (<4 mmol/l) or hyperglycemia (>11 mmol/l). RESULTS: The correlation between HbA1c and glucose was 0.48, p < 0.0001. Three of 15 patients with HbA1c >75 mmol/mol experienced significant hypoglycemia (14-144 min per day). The patients with frequent episodes of hypoglycemia could not be differentiated from those with frequent hyperglycemia by demographics or PD prescription. CONCLUSION: HbA1c and average glucose levels measured by the CGMS are only weakly correlated. On its own, HbA1c as an indicator of glycemic control in patients with diabetes on PD appears inadequate. We suggest that the CGMS technology should be more widely adopted.
INTRODUCTION: Glycated hemoglobin is used to assess diabetic control although its accuracy in dialysis has been questioned. How does it compare to the Continuous Glucose Monitoring System (CGMS) in peritoneal dialysis (PD) patients? METHODS: We conducted a retrospective analysis of 60 insulin-treated diabeticpatients on PD. We determined the mean interstitial glucose concentration and the proportion of patients with hypoglycemia (<4 mmol/l) or hyperglycemia (>11 mmol/l). RESULTS: The correlation between HbA1c and glucose was 0.48, p < 0.0001. Three of 15 patients with HbA1c >75 mmol/mol experienced significant hypoglycemia (14-144 min per day). The patients with frequent episodes of hypoglycemia could not be differentiated from those with frequent hyperglycemia by demographics or PD prescription. CONCLUSION: HbA1c and average glucose levels measured by the CGMS are only weakly correlated. On its own, HbA1c as an indicator of glycemic control in patients with diabetes on PD appears inadequate. We suggest that the CGMS technology should be more widely adopted.
Authors: Ana María Gómez; Santiago Vallejo; Freddy Ardila; Oscar M Muñoz; Álvaro J Ruiz; Mauricio Sanabria; Alfonso Bunch; Elly Morros; Laura Kattah; Maira García-Jaramillo; Fabián León-Vargas Journal: J Diabetes Sci Technol Date: 2017-09-20
Authors: Timothy S Bailey; Fang L Zhou; Rishab A Gupta; Ronald Preblick; Vineet E Gupta; Paulos Berhanu; Lawrence Blonde Journal: Diabetes Obes Metab Date: 2019-04-05 Impact factor: 6.577