| Inter-day glycemic variability assessed by continuous glucose monitoring in insulin-treated type 2 diabetes patients on hemodialysis. | |
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MedLine Citation:
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PMID: 20809678 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Type 2 diabetes patients on chronic hemodialysis have a high prevalence of cardiovascular complications and often show a poor glycemic control. Single-spot glycemic measurements are not always meaningful, and the hemoglobin A1c (HbA1c) value does not reflect short-term variations in glucose metabolism in this patient category. Therefore, to better understand their metabolic balance, we studied a group of diabetes patients on hemodialysis by a continuous glucose monitoring (CGM) system. METHODS: Twelve insulin-treated type 2 diabetes patients on hemodialysis were studied by a microdialysis-based subcutaneous glucose sensor over a period of 2 days, including the dialysis day (HD) and the following inter-dialytic period ("free" day [FD]). RESULTS: The mean 24-h glycemic value, the mean amplitude of glucose excursions, and the SD of mean glucose were significantly higher in the HD than the FD (186 ± 50 vs. 154 ± 25 mg/dL, P<0.05; 75 ± 22 vs. 56 ± 15 mg/dL, P<0.05; and 57 ± 6 vs. 35 ± 11 mg/dL, P<0.05, respectively). Considering the 48-h recording, there was a direct correlation between the mean glucose concentration and the HbA1c (r=0.47, P<0.05), whereas no association was observed between the measures of glucose variability and HbA1c. CONCLUSIONS: Insulin-treated diabetes patients on hemodialysis showed different glucose profiles between the HD and the FD. In particular, in the HD they have had an increased glycemic variability, which may represent an adjunctive risk factor for cardiovascular complications. Therefore the use of a CGM system, as a means of assessing the measures of glycemic variability, could improve the management of insulin therapy in these patients. |
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Authors:
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Marco Mirani; Cesare Berra; Silvia Finazzi; Albania Calvetta; Maria Grazia Radaelli; Flavia Favareto; Giorgio Graziani; Salvatore Badalamenti |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diabetes technology & therapeutics Volume: 12 ISSN: 1557-8593 ISO Abbreviation: Diabetes Technol. Ther. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-06 Completed Date: 2011-02-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100889084 Medline TA: Diabetes Technol Ther Country: United States |
Other Details:
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Languages: eng Pagination: 749-53 Citation Subset: IM |
Affiliation:
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Metabolic Section, Department of Internal Medicine, Istituto Clinico Humanitas, IRCCS, Rozzano, Milan, Italy. marco.mirani@humanitas.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Glucose / analysis* Diabetes Mellitus, Type 2 / blood*, complications*, drug therapy Diabetic Angiopathies / prevention & control Diabetic Nephropathies / therapy Female Hemoglobin A, Glycosylated / analysis Humans Hyperglycemia / blood* Hypoglycemia / blood* Hypoglycemic Agents / therapeutic use Insulin / therapeutic use Male Microdialysis Middle Aged Monitoring, Ambulatory* Renal Dialysis / adverse effects* Reproducibility of Results Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/hemoglobin A1c protein, human; 11061-68-0/Insulin |
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