Novel clinical associations between time in range and microangiopathies in people with type 2 diabetes mellitus on hemodialysis

J Diabetes Complications. 2023 May;37(5):108470. doi: 10.1016/j.jdiacomp.2023.108470. Epub 2023 Mar 31.

Abstract

Aims/hypothesis: We investigated associations among glucose time in range (TIR, 70-180 mg/dL), glycemic markers and prevalence of diabetic microangiopathy in people with diabetes undergoing hemodialysis (HD).

Methods: A total of 107 people with type 2 diabetes undergoing HD (HbA1c 6.4 %; glycated albumin [GA] 20.6 %) using continuous glucose monitoring were analyzed in this observational and cross-sectional study.

Results: HbA1c and GA levels significantly negatively correlated with TIR, and positively correlated with time rate of hyperglycemia, but not with time rate of hypoglycemia. TIR of 70 % corresponded to HbA1c of 6.5 % and GA of 21.2 %. The estimated HbA1c level corresponding to TIR of 70 % in this study was lower than that previously reported in people with diabetes without HD. The prevalence of diabetic neuropathy was not significantly different between people with TIR ≥ 70 % and those with TIR < 70 % (P = 0.1925), but the prevalence of diabetic retinopathy in people with TIR ≥ 70 % was significantly lower than in those with TIR < 70 % (P = 0.0071).

Conclusion/interpretation: TIR correlated with HbA1c and GA levels in people with type 2 diabetes on HD. Additionally, a higher TIR resulted in a lower rate of diabetic retinopathy.

Research in context: What is already known about this subject? What is the key question? What are the new findings? How might this impact on clinical practice in the foreseeable future?

Keywords: Continuous glucose monitoring; Glycated albumin; HbA(1c); Hemodialysis; Time in range.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose
  • Blood Glucose Self-Monitoring
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetic Retinopathy* / epidemiology
  • Glycated Hemoglobin
  • Glycated Serum Albumin
  • Glycation End Products, Advanced
  • Humans
  • Renal Dialysis / adverse effects
  • Serum Albumin
  • Vascular Diseases*

Substances

  • Blood Glucose
  • Glycated Serum Albumin
  • Glycated Hemoglobin
  • Glycation End Products, Advanced
  • Serum Albumin