The following is a summary of “Efficacy of continuous glucose monitoring in people living with diabetes and end stage kidney disease on dialysis: a systematic review,” published in the October 2024 issue of Nephrology by Zhang et al.
Patients with diabetes on dialysis face significant glucose fluctuations and hypoglycemia risk. JBDS-IP and KDIGO recommend continuous glucose monitoring (CGM) due to inaccurate hemoglobin A1c (HbA1c) levels.
Researchers conducted a prospective study to evaluate the impact of CGM on clinical outcomes in patients with diabetes on dialysis.
They conducted a search of MEDLINE(R) ALL, Ovid Emcare, Journals@Ovid Full Text, and Embase databases. Included were clinical or observational trials involving adults with Type 1 (T1D) or Type 2 (T2D) diabetes on dialysis that reported glycemic outcomes related to CGM interventions.
The results showed that of 936 citations, 49 duplicates were removed, leaving 887 screened. About 9 full texts were reviewed, with 7 excluded. Data was extracted for 2 prospective before-and-after interventional studies with no control group. Joubert et al. (2015) involved 15 T1D participants, with mean CGM levels decreasing from 8.37 mmol/L to 7.7 mmol/L (P < 0.05) and HbA1c from 6.9% to 6.5% (P < 0.05). Képénékian et al. (2014) included 29 T2D patients, with HbA1c decreasing from 8.4% to 7.6% (P < 0.01) and mean CGM values from 9.9 mmol/L to 8.9 mmol/L (P = 0.05). The frequency of glucose >10 mmol/L decreased from 41% to 30% (P < 0.05), without a significant increase in hypoglycemia. Both studies were of “good” quality.
The study concluded that evidence for the benefits of CGM in patients with diabetes on dialysis is insufficient, highlighting the need for well-designed randomized controlled trials to evaluate this technology’s advantages in this population.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03763-z
