Assessment of Glycemic Control by Continuous Glucose Monitoring, Hemoglobin A1c, Fructosamine, and Glycated Albumin in Patients With End-Stage Kidney Disease and Burnt-Out Diabetes
Authors' conclusion
The use of CGM demonstrated that patients with burnt-out diabetes have significant undiagnosed hyperglycemia. CGM and glycated albumin provide better assessment of glycemic control than do values of HbA1c and fructosamine in patients with ESKD.
Study context
- Population
- Patients with end-stage kidney disease (ESKD) on hemodialysis, with burnt-out diabetes or without a history of diabetes
- Participants
- 20 vs 20
- Exposure
- Burnt-out diabetes vs no history of diabetes
- Burnt-out diabetesn = 20
- Without diabetesn = 20reference
- Outcome
- Glycemic control by Dexcom G6 CGM metrics and glycemic markers (HbA1c, glycated albumin, fructosamine)
Main finding
As reported in the abstract
CGM metrics
- Higher continuous glucose monitoring (CGM) daily glucose, lower % time in range 70-180 mg/dL, higher % time above range (>250 mg/dL) and longer duration of hyperglycemia >180 mg/dL (hours/day) with burnt-out diabetes vs without diabetes
- Burnt-out diabetes vs Without diabetes: all P < 0.01
Observational data: associations, not effects.
Further findings
HbA1c and fructosamine
- HbA1c and fructosamine levels were similar
Glycated albumin
- Higher glycated albumin with burnt-out diabetes vs without diabetes
Original publication
Assessment of Glycemic Control by Continuous Glucose Monitoring, Hemoglobin A1c, Fructosamine, and Glycated Albumin in Patients With End-Stage Kidney Disease and Burnt-Out Diabetes. Diabetes Care. Published 12 December 2023. doi:10.
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