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Abstract: PO0919

Glycemic Status Ascertained by Continuous Glucose Monitoring in a Prospective Hemodialysis Cohort

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Narasaki, Yoko, University of California Irvine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
  • You, Amy Seung, University of California Irvine, Irvine, California, United States
  • Amel Peralta, Rene, University of California Irvine, Irvine, California, United States
  • Daza Aguilar, Andrea C., University of California Irvine, Irvine, California, United States
  • Novoa-Vargas, Alejandra, University of California Irvine, Irvine, California, United States
  • Nakata, Tracy, University of California Irvine, Irvine, California, United States
  • Nguyen, Danh V., University of California Irvine, Irvine, California, United States
  • Rhee, Connie, University of California Irvine, Irvine, California, United States
Background

Hemodialysis (HD) patients with diabetes are at heightened risk of hypo- and hyperglycemia due to multiple pathways. While self-monitored blood glucose is the standard approach for glucose assessment in HD patients, it may not adequately capture glycemic status given its infrequent nature. We thus sought to measure glucose levels using continuous glucose monitoring (CGM) as a more frequent (every 5-minutes), convenient, and automated method of glycemic status in a prospective HD cohort with diabetes.

Methods

Among 18 HD patients with diabetes hospitalized during 10/2020-5/2021, we conducted simultaneous protocolized glucose measurements using 1) CGM measured by Dexcom G6 devices vs. 2) blood glucose levels using capillary fingerstick or venous blood glucose, with the latter measured ≥4 times per day (before each meal and at night), plus every 30 minutes during HD (total of 6-8 measures during HD). Using American Diabetes Association (ADA)-defined CGM targets, we examined the prevalence of patients achieving the recommended percentage (%) of CGM levels in the ranges of <54, <70, 70-180, >180, and >250mg/dl (ADA target % of glucose levels <1%, <4%, >70%, <25%, and >5%, respectively).

Results

Whereas 64% of CGM measurements (N=9444) were within target glucose range (time in range [TIR] 70-180mg/dl), 80% of blood glucose levels (N=100) were within TIR. The proportion of patients achieving the recommended % of CGM measurements within ADA-defined glycemic ranges of >250, >180, 70-180 (target range), <70, and <54mg/dl were 67%, 44%, 44%, 89%, and 78, respectively.

Conclusion

In a cohort of hospitalized diabetic HD patients who underwent concomitant CGM and blood glucose measurements using the Dexcom G6 remote access system, blood glucose testing overestimated the % of time patients were in target glycemic range as compared with CGM. CGM showed that less than half of patients achieved the recommended % of CGM measurements within target range. Further studies are needed to determine whether CGM can improve the glycemic management of HD patients compared to conventional approaches.

Funding

  • Commercial Support