title: Glycemic pattern in diabetic patients on hemodialysis: continuous glucose monitoring (CGM) analysis.
abstract: OBJECTIVE
  Recent evidences suggest that hemodialysis (HD) induces glycemic variations in diabetic patients. Continuous glucose monitoring (CGM) devices measure interstitial glucose in a 'Holter-like' manner thereby improving the glycemic control assessment method.
  
  
  METHODS
  A CGM device (Medtronic iPRO) was used on 12 diabetic patients with chronic HD for 6 days to assess intra- and extra-dialytic interstitial glucose.
  
  
  RESULTS
  In all enrolled patients, HD was associated with a decrease of interstitial glucose values. Intradialytic glucose nadir was 79 mg/dl and it was reached at the third hour after the beginning of the session. At the end of HD, interstitial glucose increased in all patients and a glycemic peak (187 mg/dl) occurred after an average time of 2.5 h. No episodes of nocturnal hypoglycemia occurred.
  
  
  CONCLUSIONS
  HD is associated with significant intradialytic reduction of glycemia and postdialytic hyperglycemia. CGM devices result in better monitoring of glycemic trends in diabetic patients on chronic HD and could improve insulin management.
authors.affiliation: SCU Nephrology, Dialysis and Transplantation, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Presidio 'Molinette', Torino, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Gai
authors.forename: Ilenia
authors.initials: I
authors.lastname: Merlo
authors.forename: Sergio
authors.initials: S
authors.lastname: Dellepiane
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cantaluppi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Leonardi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fop
authors.forename: Cesare
authors.initials: C
authors.lastname: Guarena
authors.forename: Giorgio
authors.initials: G
authors.lastname: Grassi
authors.forename: Luigi
authors.initials: L
authors.lastname: Biancone
mesh_terms: D000368:Aged; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D045604:Extracellular Fluid / Q000737:chemistry; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D038321:Glycemic Index; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D006435:Renal Dialysis
chemical_list: D005947:Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human