title: Glycosylated hemoglobin and albumin-corrected fructosamine are good indicators for glycemic control in peritoneal dialysis patients.
abstract: OBJECTIVE
  Diabetes mellitus (DM) is the most common cause of end-stage renal disease and is an important risk factor for morbidity and mortality after dialysis. However, glycemic control among such patients is difficult to assess. The present study examined glycemic control parameters and observed glucose variation after refilling different kinds of fresh dialysate in peritoneal dialysis (PD) patients.
  
  
  METHODS
  A total of 25 DM PD patients were recruited, and continuous glucose monitoring system (CGMS) was applied to measure interstitial fluid (ISF) glucose levels at 5-min intervals for 3 days. Patients filled out diet and PD fluid exchange diaries. The records measured with CGMS were analyzed and correlated with other glycemic control parameters such as fructosamine, albumin-corrected fructosamine (AlbF), glycosylated hemoglobin (HbA1c), and glycated albumin levels.
  
  
  RESULTS
  There were significant correlations between mean ISF glucose and fructosamine (r = 0.45, P<0.05), AlbF (r = 0.54, P<0.01), and HbA1c (r = 0.51, P<0.01). The ISF glucose levels in glucose-containing dialysate increased from approximately 7-8 mg/dL within 1 hour of exchange in contrast to icodextrin dialysate which kept ISF glucose levels unchanged.
  
  
  CONCLUSIONS
  HbA1c and AlbF significantly correlated with the mean ISF glucose levels, indicating that they are reliable indices of glycemic control in DM PD patients. Icodextrin dialysate seems to have a favorable glycemic control effect when compared to the other glucose-containing dialysates.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yunlin County, Taiwan.
authors.forename: Szu-Ying
authors.initials: SY
authors.lastname: Lee
authors.forename: Yin-Cheng
authors.initials: YC
authors.lastname: Chen
authors.forename: I-Chieh
authors.initials: IC
authors.lastname: Tsai
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Yen
authors.forename: Shu-Neng
authors.initials: SN
authors.lastname: Chueh
authors.forename: Hsueh-Fang
authors.initials: HF
authors.lastname: Chuang
authors.forename: Hon-Yen
authors.initials: HY
authors.lastname: Wu
authors.forename: Chih-Kang
authors.initials: CK
authors.lastname: Chiang
authors.forename: Hui-Teng
authors.initials: HT
authors.lastname: Cheng
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
authors.forename: Jenq-Wen
authors.initials: JW
authors.lastname: Huang
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D015314:Dialysis Solutions / Q000008:administration & dosage / Q000737:chemistry; D045604:Extracellular Fluid / Q000737:chemistry; D005260:Female; D019270:Fructosamine / Q000032:analysis*; D005936:Glucans / Q000008:administration & dosage / Q000737:chemistry; D005947:Glucose / Q000008:administration & dosage / Q000737:chemistry; D006442:Glycated Hemoglobin / Q000032:analysis*; D017127:Glycation End Products, Advanced; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000592:standards*; D012709:Serum Albumin / Q000032:analysis; D000093423:Glycated Serum Albumin
chemical_list: D001786:Blood Glucose; D015314:Dialysis Solutions; D019270:Fructosamine; D005936:Glucans; D005947:Glucose; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D000077607:Icodextrin; D012709:Serum Albumin; D000093423:Glycated Serum Albumin