Diabetes screening in dialysis populations with a glucose challenge test and continuous glucose monitoring— DIGEST study
Authors' conclusion
The GCT may be a practical alternative for dysglycaemia screening in the dialysis population. The 5% TATR showed good sensitivity but poor specificity.
Study context
- Population
- Adults on dialysis at the Antwerp University Hospital without a diabetes history or glucose-lowering therapyof 50 eligible
- Participants
- 23 adults
- Comparison
- 50 g-GCT and continuous glucose monitoring (CGM) vs 75 g-OGTT for dysglycaemia detection
- Outcome
- Dysglycaemia detection
Methodological detailssingle-centre, prospective diagnostic cohort, 27 of 50 eligible declined due to oral glucose tolerance test (OGTT) burden, 50 g-GCT followed by 75 g-OGTT 8-10 days later, CGM in between
- Single-centre
- Prospective diagnostic cohort
- 27 of 50 eligible declined due to OGTT burden
- 50 g-GCT followed by 75 g-OGTT 8-10 days later, CGM in between
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity |
|---|---|---|
| Glucose challenge test (GCT) | 85% | 70% |
| 5% TATR | 92% | 12% |
Sensitivity
Glucose challenge test (GCT)85%
5% TATR92%
Specificity
Glucose challenge test (GCT)70%
5% TATR12%
- Two-step approach with GCT screening: OGTTs avoided
- 40%
- Two-step approach with GCT screening: cases missed
- 15%
Further findings
Prevalence of dysglycaemia (OGTT)
- Participants with dysglycaemia
- 13/23
Characteristics, dysglycaemia vs no dysglycaemia
- BMI (kg/m²), dysglycaemia vs none
- 26.2 ± 3.9 vs. 22.8 ± 3.3, p = 0.039
- Dialysis vintage (years), dysglycaemia vs none
- 4.5 ± 2.9 vs. 1.6 ± 1.4, p = 0.009
- Waitlisted for transplantation, dysglycaemia vs none
- 5/13 vs. 10/10, p = 0.005
- Fasting glycaemia similar between groups
Dysglycaemia by dialysis modality, haemodialysis (HD) vs peritoneal dialysis (PD)
- Dysglycaemia, HD vs PD
- 12/14 vs. 1/9, p < 0.001
CGM metrics, dysglycaemia vs none
- TIR, dysglycaemia vs none
- 95 ± 3% vs. 98 ± 3%, p = 0.020
- CV, dysglycaemia vs none
- 24% vs. 16%, p < 0.001
Original publication
Diabetes screening in dialysis populations with a glucose challenge test and continuous glucose monitoring— DIGEST study. Diabetes Obes Metab. Published 14 August 2025. doi:10.
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