title: Glycaemic control in type 2 diabetic patients on chronic haemodialysis: use of a continuous glucose monitoring system.
abstract: BACKGROUND
  The proportion of diabetic patients undergoing haemodialysis is rapidly increasing. Glucose control among such patients is difficult to assess. We aimed to evaluate the clinical performance of a continuous glucose monitoring system (CGMS) in type 2 diabetic patients on chronic haemodialysis.
  
  
  METHODS
  We used a 4-day CGMS to monitor glucose levels in 19 haemodialysed type 2 diabetic patients (HD T2) including 2 days with and 2 days without dialysis session, and 39 non-HD T2 in a double-centre study.
  
  
  RESULTS
  The glucose concentration according to the glucose meter and CGMS were correlated in HD T2 patients (r = 0.90, P < 0.0001) and in non-HD T2 patients (r = 0.81, P < 0.0001). The relative absolute difference (RAD) between glucose determined by a glucose meter and glucose determined by the CGMS did not differ between HD T2 and non-HD T2 patients (9.2 +/- 10.5 vs. 8.2 +/- 7.6%; P = 0.165). Glycated haemoglobin (A1c) and mean glucose concentration were strongly correlated in non-HD T2 patients (r = 0.71; P < 0.0001) but weakly correlated in HD T2 patients (r = 0.47; P = 0.042). Fructosamine was correlated with the mean glucose concentration in non-HD T2 (r = 0.67; P < 0.0001) but not in HD T2 patients (r = 0.04; P = 0.88).
  
  
  CONCLUSIONS
  CGM is a validated marker of glycaemic control in HD diabetic patients. This tool showed that A1c and fructosamine, despite being good markers of glycaemic control in non-HD diabetic patients, are of poor value in HD diabetic patients.
authors.affiliation: Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Riveline
authors.forename: Julie
authors.initials: J
authors.lastname: Teynie
authors.forename: Simohamed
authors.initials: S
authors.lastname: Belmouaz
authors.forename: Sylvia
authors.initials: S
authors.lastname: Franc
authors.forename: Dured
authors.initials: D
authors.lastname: Dardari
authors.forename: Marc
authors.initials: M
authors.lastname: Bauwens
authors.forename: Valérie
authors.initials: V
authors.lastname: Caudwell
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Ragot
authors.forename: Frank
authors.initials: F
authors.lastname: Bridoux
authors.forename: Guillaume
authors.initials: G
authors.lastname: Charpentier
authors.forename: Richard
authors.initials: R
authors.lastname: Marechaud
authors.forename: Samy
authors.initials: S
authors.lastname: Hadjadj
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000628:therapy*; D005260:Female; D019270:Fructosamine / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
chemical_list: D001786:Blood Glucose; D019270:Fructosamine; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human