Glycated albumin and continuous glucose monitoring to replace glycated haemoglobin in patients with diabetes treated with haemodialysis

2013 ◽  
Vol 30 (11) ◽  
pp. 1388-1389 ◽  
Author(s):  
L. Meyer ◽  
F. Chantrel ◽  
O. Imhoff ◽  
A. Sissoko ◽  
L. Serb ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Glycated Haemoglobin ◽  
Patients With Diabetes

scholarly journals The Use of HbA1c, Glycated Albumin and Continuous Glucose Monitoring to Assess Glucose Control in the Chronic Kidney Disease Population Including Dialysis

Nephron ◽  
2020 ◽  
Vol 145 (1) ◽  
pp. 14-19
Author(s):  
Tobias Bomholt ◽  
Therese Adrian ◽  
Kirsten Nørgaard ◽  
Ajenthen G. Ranjan ◽  
Thomas Almdal ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Glycated Haemoglobin ◽  
Time Data ◽  
Precise Estimation ◽  
Patients With Diabetes ◽  
Mean Glucose

<b><i>Background:</i></b> Glycated haemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) has limitations as a glycemic marker for patients with diabetes and CKD and for those receiving dialysis. Glycated albumin is an alternative glycemic marker, and some studies have found that glycated albumin more accurately reflects glycemic control than HbA<sub>1c</sub> in these groups. However, several factors are known to influence the value of glycated albumin including proteinuria. Continuous glucose monitoring (CGM) is another alternative to HbA<sub>1c</sub>. CGM allows one to assess mean glucose, glucose variability, and the time spent in hypo-, normo-, and hyperglycemia. Currently, several different CGM models are approved for use in patients receiving dialysis; CKD (not on dialysis) is not a contraindication in any of these models. Some devices are for blind recording, while others provide real-time data to patients. Small studies suggest that CGM could improve glycemic control in hemodialysis patients, but this has not been studied for individual CKD stages. <b><i>Summary:</i></b> Glycated albumin and CGM avoid the pitfalls of HbA<sub>1c</sub> in CKD and dialysis populations. However, the value of glycated albumin may be affected by several factors. CGM provides a precise estimation of the mean glucose. Here, we discuss the strengths and limitations for using HbA1c, glycated albumin, or CGM in CKD and dialysis population. <b><i>Key Messages:</i></b> Glycated albumin is an alternative glycemic marker but is affected by proteinuria. CGM provides a precise estimation of mean glucose and glucose variability. It remains unclear if CGM improves glycemic control in the CKD and dialysis populations.

735-P: Effects of Insulin Degludec in Patients with Diabetes Using Continuous Glucose Monitoring: A Scoping Review

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 735-P
Author(s):  
CHAOFAN WANG ◽  
WEN XU ◽  
XUBIN YANG ◽  
JINHUA YAN ◽  
DAIZHI YANG ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Scoping Review ◽  
Glucose Monitoring ◽  
Insulin Degludec ◽  
Patients With Diabetes

scholarly journals Assessment of Hyperglycemia, Hypoglycemia and Inter-Day Glucose Variability Using Continuous Glucose Monitoring among Diabetic Patients on Chronic Hemodialysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4116
Author(s):  
Maria Divani ◽  
Panagiotis I. Georgianos ◽  
Triantafyllos Didangelos ◽  
Vassilios Liakopoulos ◽  
Kali Makedou ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glycated Albumin ◽  
Glucose Monitoring ◽  
Area Under The Curve ◽  
Glucose Variability ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Diabetic Patients ◽  
Lower Efficiency ◽  
Target Glucose

Continuous glucose monitoring (CGM) facilitates the assessment of short-term glucose variability and identification of acute excursions of hyper- and hypo-glycemia. Among 37 diabetic hemodialysis patients who underwent 7-day CGM with the iPRO2 device (Medtronic Diabetes, Northridge, CA, USA), we explored the accuracy of glycated albumin (GA) and hemoglobin A1c (HbA1c) in assessing glycemic control, using CGM-derived metrics as the reference standard. In receiver operating characteristic (ROC) analysis, the area under the curve (AUC) in diagnosing a time in the target glucose range of 70–180 mg/dL (TIR70–180) in <50% of readings was higher for GA (AUC: 0.878; 95% confidence interval (CI): 0.728–0.962) as compared to HbA1c (AUC: 0.682; 95% CI: 0.508–0.825) (p < 0.01). The accuracy of GA (AUC: 0.939; 95% CI: 0.808–0.991) in detecting a time above the target glucose range > 250 mg/dL (TAR>250) in >10% of readings did not differ from that of HbA1c (AUC: 0.854; 95% CI: 0.699–0.948) (p = 0.16). GA (AUC: 0.712; 95% CI: 0.539–0.848) and HbA1c (AUC: 0.740; 95% CI: 0.570–0.870) had a similarly lower efficiency in detecting a time below target glucose range < 70 mg/dL (TBR<70) in >1% of readings (p = 0.71). Although the mean glucose levels were similar, the coefficient of variation of glucose recordings (39.2 ± 17.3% vs. 32.0 ± 7.8%, p < 0.001) and TBR<70 (median (range): 5.6% (0, 25.8) vs. 2.8% (0, 17.9)) were higher during the dialysis-on than during the dialysis-off day. In conclusion, the present study shows that among diabetic hemodialysis patients, GA had higher accuracy than HbA1c in detecting a 7-day CGM-derived TIR70–180 < 50%. However, both biomarkers provided an imprecise reflection of acute excursions of hypoglycemia and inter-day glucose variability.

Influence of Dialysis on the Glucose Profile in Patients with Diabetes: Usefulness of Continuous Glucose Monitoring

2014 ◽  
Vol 46 (11) ◽  
pp. 810-813 ◽  
Author(s):  
F. Chantrel ◽  
H. Sissoko ◽  
L. Képénékian ◽  
A. Smagala ◽  
L. Meyer ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glucose Profile ◽  
Patients With Diabetes
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