Kidney Week

Abstract: SA-PO0897

Continuous Glucose Monitoring improves Glycemic Profile in Patients with Diabetic Kidney Disease: IMPROVE-DKD

Session Information

• Health Maintenance, Nutrition, and Metabolism
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Lee, Sua, Hallym University Kangnam Sacred Heart Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)

Sua Lee, MD, PhD

• Park, Yohan, Konyang University Hospital, Daejeon, Korea (the Republic of)

Yohan Park, MD

• Kim, Soh Yeon, Hallym University Kangnam Sacred Heart Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)

Soh Yeon Kim, DrMed

• Lee, Ji won, Konyang University Hospital, Daejeon, Korea (the Republic of)

Ji won Lee, MD

• Kim, Do Hyoung, Hallym University Kangnam Sacred Heart Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)

Do Hyoung Kim, MD, PhD, FASN

• Kim, Eunjung, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do, Korea (the Republic of)

Eunjung Kim, MD

• Yoon, Se-Hee, Konyang University Hospital, Daejeon, Korea (the Republic of)

Se-Hee Yoon, MD, PhD

• Hwang, Won Min, Konyang University Hospital, Daejeon, Korea (the Republic of)

Won Min Hwang, MD, PhD

• Yun, Sung-Ro, Konyang University Hospital, Daejeon, Korea (the Republic of)

Sung-Ro Yun, MD, PhD

• Lee, Eun Young, Soonchunhyang University Hospital Cheonan, Cheonan-si, Chungcheongnam-do, Korea (the Republic of)

Eun Young Lee, MD, PhD

Background

Diabetic kidney disease (DKD) have glycemic variability that may not be fully captured by HbA1c or SMBG. We assessed whether CGM-guided care improves glycemic profiles in DKD.

Methods

IMPROVE-DKD study — IMportance of CGM in imPROving glycemic control and Variability in patiEnts with DKD — was a multicenter, prospective, randomized trial of adults with type 2 diabetes, CKD or maintenance HD, and HbA1c ≥7.5%. Participants were randomized to CGM-guided management or SMBG. CGM group underwent real-time CGM at weeks 1, 6, and 12 with treatment adjustment guided by CGM reports, whereas SMBG group performed SMBG ≥3 times/day and underwent blinded CGM at 12 week. Outcomes included HbA1c, mean glucose, time in range (TIR), and treatment intervention.

Results

Among 54 participants, 22 were assigned to SMBG and 32 to CGM. HbA1c decreased significantly in both groups, without between-group difference. Mean glucose increased with SMBG but decreased with CGM (+18.7±48.2 vs −15.7±35.4 mg/dL; P=0.025). At week 12, TIR was higher with CGM (61.1±23.2% vs 46.6±26.5%; P=0.049). In HD, CGM was associated with lower mean glucose (186.6±46.3 vs 232.2±61.4 mg/dL; P=0.043), higher TIR (56.5±24.3% vs 35.0±21.8%; P=0.023), and lower TAR (42.6±24.9% vs 63.6±22.3%; P=0.038). Treatment intervention was more frequent with CGM.

Conclusion

CGM-guided care improved mean glucose and glycemic profiles beyond HbA1c in DKD, particulary in HD patients. CGM may facilitate earlier intervention in high risk groups.

Figure 1. Primary glycemic outcomes in overall population

Figure 2. Glycemic outcomes in the hemodialysis population