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Kidney Week

Abstract: TH-PO1146

Hypoglycemia Is Common in Patients with Type 2 Diabetes and CKD

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Hong, Susana, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
  • Fishbane, Steven, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
  • Jhaveri, Kenar D., Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
  • Sakhiya, Vipulbhai, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
  • Zhang, Meng, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
  • Harris, Yael Tobi, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States

Group or Team Name

  • CGM Study
Background

It is unclear what the incidence of hypoglycemia is among patients with type 2 diabetes mellitus (T2DM) and non-dialysis chronic kidney disease (n-CKD). The magnitude of the problem remains largely unknown, as previous studies have generally relied on random laboratory blood testing to define hypoglycemia in this population. The purpose of our study was to use continuous glucose monitoring (CGM) to determine the frequency and severity of hypoglycemia in stable outpatients with T2DM and n-CKD.

Methods

We studied 60 patients with T2DM and n-CKD defined as eGFR 0-45 ml/min. Patients wore the CGM (Abbott FreeStyle Libre Pro) for 14 days, with glucose recorded every 15 minutes, with a maximum of 1,344 glucose measurements. Blood tests were performed in the fasting state at the end of the 14 day CGM. Hypoglycemia was defined as plasma glucose below 70 mg/dL.

Results

All 60 patients had analyzable data, having worn the CGM for a mean of 12.7±2.9 days. Mean age was 72.4±10.4 years, 75% of patients were men, 15% were black, and mean eGFR 25.6±10.5. The mean glucose concentration was 152.2±56.6 mg/dL. 47/60 (78.3%) patients had at least one hypoglycemic episode. The mean number of episodes was 7.8±9.6, with a range of 0-53 episodes. The mean number of minutes of hypoglycemia was 1574±2350. This represents a mean of 7.8±11.0% of total measurement time being hypoglycemic (figure), compared to studies in T2DM without CKD where the number is closer to 1.5%.

Conclusion

Hypoglycemia is very common among patients with T2DM and CKD. Extra glucose monitoring is advisable to avoid adverse events.

Funding

  • Clinical Revenue Support