Hemodialysis-Related Glycemic Disarray Proven by Continuous Glucose Monitoring; Glycemic Markers and Hypoglycemia
Hemodialysis-Related Glycemic Disarray Proven by Continuous Glucose Monitoring; Glycemic Markers and Hypoglycemia
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DOI：
10.2337/dc21-0269
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发表时间：
2021-07-01
期刊：
影响因子：
16.2
通讯作者：
Shichiri, Masayoshi
中科院分区：
文献类型：
--
作者：
Hayashi, Akinori;Shimizu, Naoya;Shichiri, Masayoshi
目的使用无葡萄糖透析液进行血液透析（HD）时，发生无症状低血糖的风险很高;因此，在透析液中加入葡萄糖被认为可以预防透析中低血糖。然而，尚未确定使用含>100 mg/dL葡萄糖的透析液的准确血糖波动曲线和无症状低血糖的频率。研究设计和方法：我们评估了98例2型糖尿病患者的血糖曲线，其中68例为男性，这些患者接受了HD（HbA（1c）6.4 +/- 1.2%;糖化白蛋白20.8 +/- 6.8%），使用含有100、125或150 mg/dL葡萄糖的透析液，使用连续葡萄糖监测。结果：探头葡萄糖水平（SGL）在HD期间持续降低，与透析液葡萄糖浓度无关，49名参与者（50%）达到低于透析液葡萄糖浓度的最低值。21例受试者（21%）出现HD相关低血糖，定义为SGL
OBJECTIVE There is a high risk of asymptomatic hypoglycemia associated with hemodialysis (HD) using glucose-free dialysate; therefore, the inclusion of glucose in the dialysate is believed to prevent intradialytic hypoglycemia. However, the exact glycemic fluctuation profiles and frequency of asymptomatic hypoglycemia using dialysates containing >100 mg/dL glucose have not been determined. RESEARCH DESIGN AND METHODS We evaluated the glycemic profiles of 98 patients, 68 of whom were men, with type 2 diabetes undergoing HD (HbA(1c) 6.4 +/- 1.2%; glycated albumin 20.8 +/- 6.8%) with a dialysate containing 100, 125, or 150 mg/dL glucose using continuous glucose monitoring. RESULTS Sensor glucose level (SGL) showed a sustained decrease during HD, irrespective of the dialysate glucose concentration, and reached a nadir that was lower than the dialysate glucose concentration in 49 participants (50%). Twenty-one participants (21%) presented with HD-related hypoglycemia, defined by an SGL