Endocrine Abstracts

Diabetes (DM) is the leading cause of end-stage-renal disease (ESRD). Majority of T2DM patients (Pts) with ESRD need insulin. Kidneys play significant role in exogenous insulin metabolism. Chronic renal disease is associated with alterations in insulin metabolism and glycemic control. As renal function starts to decline, insulin requirement needs to be adjusted to reach euglycemia.

A good metabolic control is not only important in the early phase of diabetic nephropathy but also in diabetic Pts with ESRD. Glycemic control can reduce the progression of atherosclerosis and improve the survival in Pts treated with hemodialysis (HD).

Zahra nephrology center is located close to Tripoli (40 Km) with 180 Pts on HD (~8% of total HD Pts).

Aim: Evaluate the effect of HD on pre to post dialysis in insulin requirements to achieve euglycemia.

Method: 11 Pts (6 male) were included. Average age 59.7 years, mean duration of DM 20 years, 75% were on insulin (pre mixed) prior to HD. Mean duration of HD was 4.5 years, 3 sessions a week.

Pts were admitted to our hospital, insulin physiological regimen (basal & bolus) was applied to maintain euglycemia (BS=100–140 mg/dl). Insulin is adjusted hourly pre,during and post-HD, and investigation compared day-to-day insulin requirements.

Result: Early results should that ESRD due to diabetic nephropathy is counted for 15% in our center. Since HD was started, insulin requirements were reduced in 91%. 3 Pts are off treatment since HD (2 pts were in oral therapy). Insulin was reduced by 75 to 50% in 5 Pt and by 40 to 25% in the rest of the Pts. Only one Pt kept in the same dose.

All Pts are off insulin on HD day, and all of them were experienced hypoglycemic attacks.

Rest of results well be published by the meeting time when are completed.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.