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Glucose management in diabetic patients undergoing hemodialysis

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Abstract

The number of diabetic patients undergoing hemodialysis in Japan is increasing. These patients are likely to have other diabetic complications and a high risk of cardiovascular disease. Therefore, accurate, yet cautious, diabetes management is required. Challenges in glycemic control exist because of the dialysis process itself in addition to altered glucose metabolism, a propensity for hypoglycemia, and the limited use of antidiabetic medication. To assess glycemic control, glycemic markers, such as a single blood glucose measurement or glycated albumin, are useful. Fluctuations in glucose levels during and after hemodialysis and between dialysis days and non-dialysis days also present challenges in maintaining appropriate glycemic control. To attenuate these fluctuations, modification in the use of antidiabetic agents is necessary. Finally, we present representative cases to indicate that continuous glucose monitoring appears to be clinically useful for assessing glycemic control in these patients.

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Authors and Affiliations

  1. Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Miyako Kishimoto

  2. Diabetes and Metabolism Information Center, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Miyako Kishimoto & Mitsuhiko Noda

  3. Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Mitsuhiko Noda

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Kishimoto, M., Noda, M. Glucose management in diabetic patients undergoing hemodialysis. Diabetol Int 5, 84–91 (2014). https://doi.org/10.1007/s13340-014-0171-1

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