Affiliation:
1. Department of Medicine, Cantonal Hospital Frauenfeld, Frauenfeld,
Switzerland
2. Clinic for Transplantation Immunology and Nephrology, University
Hospital Basel, University of Basel, Basel, Switzerland
Abstract
Abstract
Aims Glucose and insulin metabolism are altered in hemodialysis patients,
and diabetes management is difficult in these patients. We aimed to validate
flash glucose monitoring (FGM) in hemodialysis patients with and without
diabetes mellitus as an attractive option for glucose monitoring not requiring
regular self-punctures.
Methods We measured interstitial glucose using a FreeStyle Libre device in
eight hemodialysis patients with and seven without diabetes mellitus over 14
days and compared the results to simultaneously performed self-monitoring of
capillary blood glucose (SMBG).
Results In 720 paired measurements, mean flash glucose values were
significantly lower than self-measured capillary values (6.17±2.52 vs.
7.15±2.41 mmol/L, p=1.3 E-86). Overall, the mean
absolute relative difference was 17.4%, and the mean absolute difference
was 1.20 mmol/L. The systematic error was significantly larger
in patients without vs. with diabetes (− 1.17 vs.
− 0.82 mmol/L) and on dialysis vs. interdialytic
days (−1.09 vs. −0.90 mmol/L). Compared to
venous blood glucose (72 paired measurements), the systematic error of FGM was
even larger (5.89±2.44 mmol/L vs.
7.78±7.25 mmol/L, p=3.74E-22). Several
strategies to reduce the systematic error were evaluated, including the addition
of +1.0 mmol/L as a correction term to all FGM values,
which significantly improved accuracy.
Conclusions FGM systematically underestimates blood glucose in
hemodialysis patients but, taking this systematic error into account, the system
may be useful for glucose monitoring in hemodialysis patients with or without
diabetes.
Subject
Endocrinology,General Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
1 articles.
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