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Endocrine Abstracts (2024) 99 EP33 | DOI: 10.1530/endoabs.99.EP33

1National Institute of Nutrition and Food Technology, Department of Nutritional Diseases (D), Tunis, Tunisia; 2Charles Nicolle Hospital, Internal Medicine department, Tunis, Tunisia; 3, Tunisia


Introduction: Glycemic control in diabetic patients undergoing hemodialysis is difficult to achieve because of the high glycemic variability in this population. The aim of our study was to assess the glycemic profile, using the continuous glucose monitoring system ‘CGMS’, in a group of insulin-treated diabetic patients on hemodialysis.

Methods: We conducted a descriptive, evaluative, longitudinal study involving insulin-treated diabetic patients undergoing hemodialysis. It was bi-centric in the National Institute of Nutrition and the Nephrology Department of Charles Nicolle Hospital between 2021 and 2022. We used a 7-day CGMS (Medtronic; Guardian 3) to monitor glucose levels including the dialysis days (HD) and the following inter-dialytic periods (‘free’ day [FD]).

Results: CGM data were available for 30 subjects (19 male) with a mean age of 57±15.5 years and mean diabetes duration of 21.4±6.9 years. The mean glucose management index (GMI) which provides an estimated glycated hemoglobin (A1c) level was 8.1±1.2%. The mean interstitial blood glucose was 210.7±50.5 mg/dl, with no significant difference between FD and HD (213.9±59.9 mg/dl vs. 217.6±52.4 mg/dl, p=NS). The mean coefficient of variation (CV) was 35±8.7%. It was lower during FD (27.6±9.7% vs. 30.2±9.9%) with no significant difference (p=NS). However, the mean amplitude of glucose excursions (MAGE) and the standard deviation (SD) were significantly higher during the dialysis day than FD (93.7±35.8 mg/dl vs. 111.4±39.1 mg/dl, P=0.01 and 49.5±28.8 mg/dl vs. 62.4±18.8 mg/dl, P=0.04, respectively).

Conclusion: In this population of diabetic patients with end stage kidney disease undergoing hemodialysis, glycemic profile was shown differently between the HD and the FD. Therefore, the use of a CGMS to monitor glycemic control could improve the management of insulin therapy in these patients.

Volume 99

26th European Congress of Endocrinology

Stockholm, Sweden
11 May 2024 - 14 May 2024

European Society of Endocrinology 

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