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Abstract: TH-OR54

Glycemic Patterns of Peritoneal Dialysis Patients Assessed by Continuous Glucose Monitoring

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Ashford, Nathaniel, Kidney Research Institute, Seattle, Washington, United States
  • Mayeda, Laura, University of Washington School of Medicine, Seattle, Washington, United States
  • Zelnick, Leila R., Kidney Research Institute, Seattle, Washington, United States
  • Anderson, Lisa D., Kidney Research Institute, Seattle, Washington, United States
  • Jones, Evelin Noemi, Kidney Research Institute, Seattle, Washington, United States
  • Trikudanathan, Subbulaxmi, UW Diabetes Institute, Seattle, Washington, United States
  • Marnell, Christopher, Northwest Kidney Centers, Seattle, Washington, United States
  • Hirsch, Irl B., UW Diabetes Institute, Seattle, Washington, United States
  • Hall, Yoshio N., Kidney Research Institute, Seattle, Washington, United States
  • De Boer, Ian, Kidney Research Institute, Seattle, Washington, United States

Group or Team Name

  • Kidney Research Institute.
Background

Peritoneal dialysis (PD) utilizes hypertonic dextrose solution, resulting in known complications with the peritoneal membrane, and absorption into the systemic system. Glucose absorbed from the peritoneal cavity likely leads to insulin resistance and hyperglycemia, but we have limited knowledge about the glycemic patterns of PD patients.

Methods

The BLOSSOM study observed dysglycemia in dialysis patients. Participants wore a Dexcom G6 Pro continuous glucose monitor (CGM) for up to 10 days and completed PD prescription diaries. This interim analysis describes glycemic patterns during day (8:00-20:00) and night (20:00-8:00) in this population.

Results

We enrolled 40 participants treated with PD[AN1] , 23 with diabetes mellitus (DM) with and 17 without. Hemoglobin A1C (SD) for participants with DM was 7.3% (1.7%). Mean BG was high, and time in range (TIR) was low (TIR above 70% is recommended) for PD participants with and without DM (Table). At night, high blood glucose levels were seen, and this persisted throughout the day. Dialysate 2.5% dextrose groups had the highest nighttime blood glucose levels (Figure).

Conclusion

Persistent hyperglycemia was seen in PD patients night and day. TIR was far below target for participants with DM, who spent about a third of time >250 mg/dL. PD patients without DM were in target range only about half the time. Our data suggest a need to closely monitor PD patients for dysglycemia regardless of diabetes status.

CGM Statistics
 No diabetes (N = 17)Diabetes (N = 23)
AllNight1DayAllNightDay
Mean blood glucose (mg/dL) (SD)142 (19)145 (19)138 (20)223 (62)232 (71)215 (58)
Glucose management indicator2 (%) (SD)6.7 (0.5)8.7 (1.5)
Time in range3 %(SD)54 (27)49 (30)60 (25)38 (27)34 (28)41 (27)
Time above 250 mg/dL %(SD)0 (1)1 (2)0 (1)32 (29)35 (34)28 (27)

120:00-8:00;2Mean glucose derived from CGM, complementing HbA1c for glycemic assessment. ;3TIR 70 –140 mg/dL for participants without DM. TIR 70-180 mg/dL for participants with DM

Funding

  • NIDDK Support