ABSTRACT
BACKGROUND: In patients with diabetes related end-stage renal disease (ESRD) on hemodialysis, blood glucose management can be challenging due to the kinetics of glucose and insulin in addition to other factors. The glucose monitoring systems which measure glucose levels continuously may be useful to study the glucose profile of patients with diabetes undergoing hemodialysis. Our study is designed to use ambulatory glucose profile to study the glucose pattern - during, before, and after a session of hemodialysis. MATERIALS AND METHODS: Ten patients with type 2 diabetes with ESRD undergoing hemodialysis were recruited. Forty-eight glucose readings were recorded in a 12-h period which included 4 h each prior, during, and after the dialysis session with a flash glucose monitor (FreeStyle Libre-pro). The same 12 h time frame was also monitored on a non-dialysis day. RESULTS: On the day of dialysis, the mean glucose level was significantly lower (P = 0.013) compared to the day without dialysis (95 ± 12.7 mg/dl vs 194 ± 76.8 mg/dl). As compared to the pre-dialysis period, the mean blood glucose levels during dialysis were lower (P = 0.004). As compared to the dialysis period, the mean blood glucose levels in the post-dialysis period were higher but did not reach statistical significance. CONCLUSION: In our study, subjects with type 2 diabetes on hemodialysis had lower glucose levels on the day of dialysis compared to non-dialysis day. Glucose levels showed a fall during hemodialysis and then a rise to higher levels after dialysis.
ABSTRACT
CONTEXT: Gestational diabetes mellitus (GDM) should be diagnosed early, as untreated maternal hyperglycemia leads to adverse materno-fetal outcome. SUBJECTS AND METHODS: We studied prevalence of gestational diabetes by a house to house survey of a rural population in western India. A cluster of remote villages with little access to health care were chosen. RESULTS: A total of 989 women participated in the study out of which 9.5% (n = 94) were diagnosed as GDM. In a stepwise multivariate regression analysis a higher body mass index during pregnancy was a predictor of gestational diabetes. The prevalence of diabetes was similar in women with gestational age of >24 weeks and <24 weeks, suggesting the need for early screening. CONCLUSIONS: Our results suggest the need for implementing health programs to diagnose and treat gestational diabetes in this population.
