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CGM Linked to More Time in Range
In a randomized crossover trial of insulin-treated patients receiving hemodialysis, real-time continuous glucose monitoring did not improve the primary hypoglycemia outcome but increased time in range and reduced time above range vs capillary testing.
Real-time continuous glucose monitoring (CGM) improved secondary glycemic measures among insulin-treated type 2 diabetes patients on hemodialysis, including time in range and mean glucose levels.
Background
Continuous glucose monitoring is increasingly recognized for its potential to enhance glycemic control in patients with diabetes. This study specifically addresses the impact of CGM in a complex population of insulin-treated type 2 diabetes patients undergoing maintenance hemodialysis, a group at high risk for glycemic variability and hypoglycemia.
Data Highlights
Measure
Real-Time CGM
Capillary Testing
Time in Range (70-180 mg/dL)
63%
55%
Time Above 180 mg/dL
35%
44%
Mean Glucose
174 mg/dL
188 mg/dL
Time Below 70 mg/dL
1.2%
1.3%
Key Findings
Real-time CGM improved mean time in the target range (63% vs 55% with capillary testing).
Time above 180 mg/dL was lower with CGM (35%) compared to capillary testing (44%).
Mean glucose levels were significantly lower during CGM (174 mg/dL) than during capillary testing (188 mg/dL).
Time below 70 mg/dL did not differ significantly between the two monitoring methods.
Approximately 79% of patients experienced glucose below 70 mg/dL during CGM, compared to 72% during capillary testing.
Hyperglycemic episodes remained common, with all patients experiencing glucose above 180 mg/dL in both periods.
Clinical Implications
The findings indicate that real-time CGM may enhance glycemic control metrics in insulin-treated patients on hemodialysis.
Conclusion
Real-time continuous glucose monitoring demonstrated improvements in glycemic control metrics.
