title: Effectiveness of continuous glucose monitoring in dialysis patients with diabetes: the DIALYDIAB pilot study.
abstract: OBJECTIVE
  The DIALYDIAB trial addresses the contribution of iterative sequences of continuous glucose monitoring (CGM) on glucose control in dialysis patients with diabetes.
  
  
  METHODS
  In this before-after monocentric 12-week pilot study, dialysis patients with diabetes were monitored with self-monitoring blood glucose (SMBG) 3 times per day during a 6-week period followed by a 5-day CGM recording at 2-week interval during another 6-week period. SMBG and CGM profiles were remotely analyzed by a single diabetes expert who gave therapeutic counseling to dialysis physicians.
  
  
  RESULTS
  Fifteen patients who entered the study had a male/female ratio 8/7, age 60.9±14.8 years, BMI 29.9±7.8, diabetes duration 19.2±8.5 years and dialysis duration 6.5±6.9 years. Treatments were diet alone (20%) or diet plus insulin (80%). Mean CGM glucose level was 8.3±2.5 mmol/l at baseline (T0), 8.2±1.6 mmol/l at the end of the SMBG period (T1) (ns) and 7.7±1.6 mmol/l at the end of the CGM period (T2) (p<0.05 vs. T0). Glucose AUC>10 mmol/l was 0.9±1.4 mmol/l/day at T0 and decreased to 0.4±0.5 at T2 (p<0.05)) without change in glucose AUC<3.3 mmol/l. Treatment adaptation was higher during the CGM period (1.4±1.0 and 2.1±0.9 treatment change at T1 and T2, respectively; p<0.05).
  
  
  CONCLUSIONS
  In patients with diabetes on chronic dialysis, iterative CGM monitoring was associated with more frequent treatment changes and finally, better glucose control, without increased risk of hypoglycemia.
authors: Diabetes Care Unit, University Hospital of Caen, France. Electronic address: joubert-m@chu-caen.fr.
authors: Michael
authors: M
authors: Joubert
authors: Diabetes Care Unit, University Hospital of Caen, France.
authors: Corinne
authors: C
authors: Fourmy
authors: Dialysis Unit, University Hospital of Caen, France.
authors: Patrick
authors: P
authors: Henri
authors: Dialysis Unit, University Hospital of Caen, France.
authors: Maxence
authors: M
authors: Ficheux
authors: Dialysis Unit, University Hospital of Caen, France.
authors: Thierry
authors: T
authors: Lobbedez
authors: Diabetes Care Unit, University Hospital of Caen, France.
authors: Yves
authors: Y
authors: Reznik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000379:methods; D003920:Diabetes Mellitus / Q000097:blood* / Q000628:therapy; D003928:Diabetic Nephropathies / Q000097:blood* / Q000628:therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Continuous glucose monitoring; Diabetes; End-stage renal disease; Hemodialysis