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Kidney Week

Abstract: PO0772

Hypoglycemia and Glycemic Status Ascertained by Continuous Glucose Monitoring vs. Blood Glucose in a Prospective Hemodialysis Cohort

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Rhee, Connie, University of California Irvine, Irvine, California, United States
  • Narasaki, Yoko, 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
  • Guerrero, Yalitzi, 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
  • Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
Background

In non-CKD patients, evidence shows continuous glucose monitoring (CGM) provides convenient, automated, and less invasive measurements vs. conventional self-monitored blood glucose, and leads to reduced hypo-/hyperglycemia and glycemic variability (hypoglycemia risk factor), as well as increased time in goal glucose range and quality of life. However, accuracy of CGM interstitial glucose vs. gold-standard blood glucose measures has not been well-studied in dialysis patients.

Methods

In 18 HD patients with diabetes hospitalized during 10/2020-5/2021, we conducted simultaneous protocolized glucose measurements using 1) Dexcom G6 CGM 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. We examined the correlation of averaged CGM and blood glucose levels, and compared the prevalence of hypoglycemia detected by these methods.

Results

During the overall assessment period, Pearson and Spearman correlations for averaged CGM vs. blood glucose were 0.65 and 0.66; similar correlations were observed when stratified by HD vs. non-HD periods. A similar proportion of patients were identified as having American Diabetes Association (ADA) Level 1 Hypoglycemia (<70mg/dl) using CGM and blood glucose (33%). In contrast, a higher proportion of patients were identified as having ADA Level 2 Hypoglycemia (<54mg/dl) by CGM (33%) vs. blood glucose (11%). A similar proportion of patients were identified as having high glucose variability (%CV >36%) using CGM vs. blood glucose (11%).

Conclusion

In a prospective cohort of hospitalized HD patients with diabetes, CGM interstitial glucose via the Dexcom G6 remote access system showed similar correlation with blood glucose levels. Whereas CGM vs. blood glucose had similar detection of Level 1 Hypoglycemia, CGM had greater detection of Level 2 Hypoglycemia vs. conventional approaches.

Funding

  • Commercial Support