Glycosylated Hemoglobin and Albumin-Corrected Fructosamine Are Good Indicators for Glycemic Control in Peritoneal Dialysis Patients
Journal
PLoS ONE
Journal Volume
8
Journal Issue
3
Pages
e57762
Date Issued
2013
Author(s)
Chen Y.-C.
Tsai I.-C.
Chueh S.-N.
Chuang H.-F.
Wu H.-Y.
Abstract
Purpose: 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. Conclusion: 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. ? 2013 Lee et al.
SDGs
Other Subjects
antidiabetic agent; fructosamine; glucose; glycosylated albumin; hemoglobin A1c; icodextrin; insulin; accuracy; adult; article; blood glucose monitoring; clinical article; continuous ambulatory peritoneal dialysis; diabetes mellitus; dialysate; diet therapy; female; glycemic control; human; male; peritoneal dialysis; tissue pressure; Aged; Blood Glucose; Diabetes Mellitus, Type 2; Dialysis Solutions; Extracellular Fluid; Female; Fructosamine; Glucans; Glucose; Hemoglobin A, Glycosylated; Humans; Kidney Failure, Chronic; Male; Middle Aged; Monitoring, Physiologic; Peritoneal Dialysis, Continuous Ambulatory; Serum Albumin
Type
journal article