Blood Glucose Control in Patients With Diabetes and Kidney Failure

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Adequacy of glycemic control in hemodialysis patients with diabetes, by D.J. Tascona and colleagues. Diabetes Care 29:2247-2251, 2006.

What is the problem and what is known about it so far?

Diabetes can damage the kidneys and cause them to fail. Failing kidneys lose their ability to filter out waste products, resulting in kidney disease. End-stage kidney disease is when the disease is caught too late, and the kidneys fail.

Why did the researchers do this particular study?

Previous studies have shown that maintaining good blood glucose control can help prevent most complications of diabetes. The researchers wanted to see how common good or bad blood glucose control was among patients who had kidney failure.

Who was studied?

One hundred patients with diabetes who were on hemodialysis to treat kidney failure.

Hemodialysis uses a machine, a dialyzer, to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to the dialyzer, which removes wastes and extra fluid, and the cleaned blood then goes back into the body.

How was the study done?

The researchers reviewed various health-related measures of the patients. These included long-term blood glucose control (A1C), how long they had diabetes, whether they used insulin to treat diabetes, and whether they had heart or blood vessel problems.

What did the researchers find?

Fifty-four of 100 patients had poor blood glucose control. These patients typically had diabetes for longer periods of time and also had more heart and/or blood vessel problems.

What are the limitations to the study?

All of the patients in this study were from southeastern Ontario, Canada. Other patient populations may show different results.

The individual cause of kidney failure was not identified for each patient.

The study did not consider the frequency of hypoglycemia (when blood glucose levels drop too low, often called “insulin reactions”) among those patients who had good A1C levels.

What are the implications of the study?

For diabetes patients who are on hemodialysis, maintaining good blood glucose control can help prevent further complications and improve quality of life. Family doctors or nephrologists should use regular hemodialysis time as an opportunity for diabetes education and for making adjustments based on patients’ blood glucose monitoring.

FOR MORE INFORMATION

Kidney Disease (Nephropathy)

A1C Test

Uncomplicated Guide to Diabetes Complications