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Use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment
BACKGROUND: Studies highlight the inaccuracy of glycated hemoglobin (HbA1c) for the assessment of glycemic control in dialysis diabetics and suggest the use of continuous glucose monitoring (CGM) as an alternative. Of the CGMs, FreeStyle Libre(®) is the most used in worldwide, but there is still no...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501745/ https://www.ncbi.nlm.nih.gov/pubmed/34625090 http://dx.doi.org/10.1186/s13098-021-00722-8 |
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author | Hissa, Marcelo Rocha Nasser Hissa, Priscilla Nogueira Gomes Guimarães, Sérgio Botelho Hissa, Miguel Nasser |
author_facet | Hissa, Marcelo Rocha Nasser Hissa, Priscilla Nogueira Gomes Guimarães, Sérgio Botelho Hissa, Miguel Nasser |
author_sort | Hissa, Marcelo Rocha Nasser |
collection | PubMed |
description | BACKGROUND: Studies highlight the inaccuracy of glycated hemoglobin (HbA1c) for the assessment of glycemic control in dialysis diabetics and suggest the use of continuous glucose monitoring (CGM) as an alternative. Of the CGMs, FreeStyle Libre(®) is the most used in worldwide, but there is still no consensus on its use in dialysis. METHOD: A 3-week prospective study was performed with 12 patients comparing capillary and interstitial glucose during dialysis. RESULTS: Comparing capillary and interstitial measurements, similar values were observed in pre-dialysis in the 1st week (184.1 ± 69.5 mg/dl and 173.1 ± 78.9 mg/dl, respectively, p = 0.303), in patients with body mass index less than 24.9 kg/m(2) (214.2 ± 72.2 mg/dl and 201.3 ± 77.0 mg/dl respectively, p = 0.466), in those dialysis fluid loss less than 2 l (185.5 ± 82.6 mg/dl and 183.1 ± 94.0 mg/dl respectively and p = 0.805) and in those with hemoglobin greater than 12 g/dl (152.0 ± 35, 5 mg/dl and 129.5 ± 47.4 mg/dl respectively, p = 0.016). In the correlation of the capillary measurement with the interstitial sensor, it was observed that the proportions in the Clarke Error Grid of zone A, zone B, zone C, zone D and zone E were 62.5%, 27.1%, 0.0%, 10.4% and 0.0% respectively and in the Parkes error grid in zone A, zone B, zone C, zone D and zone E were 80.6%, 9.7%, 9.7% 0.0% and 0.0%, respectively. CONCLUSION: The mean absolute relative difference in dialysis patients is higher than the general population without end-stage renal disease. However, clinical decision-making based on the values measured by the system can be made with a good margin based on the correlation between interstitial and capillary measurements. |
format | Online Article Text |
id | pubmed-8501745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-85017452021-10-20 Use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment Hissa, Marcelo Rocha Nasser Hissa, Priscilla Nogueira Gomes Guimarães, Sérgio Botelho Hissa, Miguel Nasser Diabetol Metab Syndr Research BACKGROUND: Studies highlight the inaccuracy of glycated hemoglobin (HbA1c) for the assessment of glycemic control in dialysis diabetics and suggest the use of continuous glucose monitoring (CGM) as an alternative. Of the CGMs, FreeStyle Libre(®) is the most used in worldwide, but there is still no consensus on its use in dialysis. METHOD: A 3-week prospective study was performed with 12 patients comparing capillary and interstitial glucose during dialysis. RESULTS: Comparing capillary and interstitial measurements, similar values were observed in pre-dialysis in the 1st week (184.1 ± 69.5 mg/dl and 173.1 ± 78.9 mg/dl, respectively, p = 0.303), in patients with body mass index less than 24.9 kg/m(2) (214.2 ± 72.2 mg/dl and 201.3 ± 77.0 mg/dl respectively, p = 0.466), in those dialysis fluid loss less than 2 l (185.5 ± 82.6 mg/dl and 183.1 ± 94.0 mg/dl respectively and p = 0.805) and in those with hemoglobin greater than 12 g/dl (152.0 ± 35, 5 mg/dl and 129.5 ± 47.4 mg/dl respectively, p = 0.016). In the correlation of the capillary measurement with the interstitial sensor, it was observed that the proportions in the Clarke Error Grid of zone A, zone B, zone C, zone D and zone E were 62.5%, 27.1%, 0.0%, 10.4% and 0.0% respectively and in the Parkes error grid in zone A, zone B, zone C, zone D and zone E were 80.6%, 9.7%, 9.7% 0.0% and 0.0%, respectively. CONCLUSION: The mean absolute relative difference in dialysis patients is higher than the general population without end-stage renal disease. However, clinical decision-making based on the values measured by the system can be made with a good margin based on the correlation between interstitial and capillary measurements. BioMed Central 2021-10-09 /pmc/articles/PMC8501745/ /pubmed/34625090 http://dx.doi.org/10.1186/s13098-021-00722-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Hissa, Marcelo Rocha Nasser Hissa, Priscilla Nogueira Gomes Guimarães, Sérgio Botelho Hissa, Miguel Nasser Use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment |
title | Use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment |
title_full | Use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment |
title_fullStr | Use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment |
title_full_unstemmed | Use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment |
title_short | Use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment |
title_sort | use of continuous glucose monitoring system in patients with type 2 mellitus diabetic during hemodialysis treatment |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501745/ https://www.ncbi.nlm.nih.gov/pubmed/34625090 http://dx.doi.org/10.1186/s13098-021-00722-8 |
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