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  • Title: Effectiveness of continuous glucose monitoring in dialysis patients with diabetes: the DIALYDIAB pilot study.
    Author: Joubert M, Fourmy C, Henri P, Ficheux M, Lobbedez T, Reznik Y.
    Journal: Diabetes Res Clin Pract; 2015 Mar; 107(3):348-54. PubMed ID: 25638452.
    Abstract:
    AIMS: The DIALYDIAB trial addresses the contribution of iterative sequences of continuous glucose monitoring (CGM) on glucose control in dialysis patients with diabetes. MATERIALS AND 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.
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