In:
Nephron, S. Karger AG, Vol. 146, No. 2 ( 2022), p. 146-152
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Shortened erythrocyte life span and erythropoietin-stimulating agents may affect hemoglobin A 〈 sub 〉 1c 〈 /sub 〉 (HbA 〈 sub 〉 1c 〈 /sub 〉 ) levels in patients receiving peritoneal dialysis (PD). We compared HbA 〈 sub 〉 1c 〈 /sub 〉 with interstitial glucose measured by continuous glucose monitoring (CGM) in patients with type 2 diabetes receiving PD. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Fourteen days of CGM (Ipro2, Medtronic) were performed in 23 patients with type 2 diabetes receiving PD and in 23 controls with type 2 diabetes and an estimated glomerular filtration rate over 60 mL/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 . Patients were matched on gender and age (±5 years). HbA 〈 sub 〉 1c 〈 /sub 〉 (mmol/mol), its derived estimate of mean plasma glucose (eMPG 〈 sub 〉 A1c 〈 /sub 〉 ) (mmol/L), and fructosamine (µmol/L) were measured at the end of the CGM period and compared with the mean sensor glucose (mmol/L) from CGM. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In the PD group, mean sensor glucose was 0.98 (95% confidence interval (CI): 0.43–1.54) mmol/L higher than the eMPG 〈 sub 〉 A1c 〈 /sub 〉 compared with the control group ( 〈 i 〉 p 〈 /i 〉 = 0.002) where glucose levels were nearly identical (−0.05 (95% CI: −0.35–0.25) mmol/L). A significant association was found between fructosamine and mean sensor glucose using linear regression with no difference between slopes ( 〈 i 〉 p 〈 /i 〉 = 0.89) or y-intercepts ( 〈 i 〉 p 〈 /i 〉 = 0.28). 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 HbA 〈 sub 〉 1c 〈 /sub 〉 underestimates mean plasma glucose levels in patients with type 2 diabetes receiving PD. However, the clinical significance of this finding is undetermined. Fructosamine seems to more accurately reflect glycemic status. CGM or fructosamine could complement HbA 〈 sub 〉 1c 〈 /sub 〉 to increase the accuracy of glycemic monitoring in the PD population.
Type of Medium:
Online Resource
ISSN:
1660-8151
,
2235-3186
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
2810853-X
