Glycaemic control in type 2 diabetic patients on chronic haemodialysis: use of a continuous glucose monitoring system. - Archive ouverte HAL
Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2009

Glycaemic control in type 2 diabetic patients on chronic haemodialysis: use of a continuous glucose monitoring system.

Résumé

BACKGROUND: The proportion of diabetic patients undergoing haemodialysis is rapidly increasing. Glucose control among such patients is difficult to assess. We aimed to evaluate the clinical performance of a continuous glucose monitoring system (CGMS) in type 2 diabetic patients on chronic haemodialysis. METHODS: We used a 4-day CGMS to monitor glucose levels in 19 haemodialysed type 2 diabetic patients (HD T2) including 2 days with and 2 days without dialysis session, and 39 non-HD T2 in a double-centre study. RESULTS: The glucose concentration according to the glucose meter and CGMS were correlated in HD T2 patients (r = 0.90, P < 0.0001) and in non-HD T2 patients (r = 0.81, P < 0.0001). The relative absolute difference (RAD) between glucose determined by a glucose meter and glucose determined by the CGMS did not differ between HD T2 and non-HD T2 patients (9.2 +/- 10.5 vs. 8.2 +/- 7.6%; P = 0.165). Glycated haemoglobin (A1c) and mean glucose concentration were strongly correlated in non-HD T2 patients (r = 0.71; P < 0.0001) but weakly correlated in HD T2 patients (r = 0.47; P = 0.042). Fructosamine was correlated with the mean glucose concentration in non-HD T2 (r = 0.67; P < 0.0001) but not in HD T2 patients (r = 0.04; P = 0.88). CONCLUSION: CGM is a validated marker of glycaemic control in HD diabetic patients. This tool showed that A1c and fructosamine, despite being good markers of glycaemic control in non-HD diabetic patients, are of poor value in HD diabetic patients.

Domaines

Immunologie

Dates et versions

hal-00453221 , version 1 (04-02-2010)

Identifiants

Citer

Jean-Pierre Riveline, Julie Teynie, Simohamed Belmouaz, Sylvia Franc, Dured Dardari, et al.. Glycaemic control in type 2 diabetic patients on chronic haemodialysis: use of a continuous glucose monitoring system.. Nephrology Dialysis Transplantation, 2009, 24 (9), pp.2866-71. ⟨10.1093/ndt/gfp181⟩. ⟨hal-00453221⟩
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