Glucotypes in patients with type 2 diabetes and either diabetic kidney disease or end stage kidney disease under different anti-diabetic treatments.

BACKGROUND

The profile of glycemic changes in diabetic kidney disease (DKD) remains unclear. Therefore, we aimed to evaluate glucotypes in patients with type 2 diabetes and end stage kidney disease (ESKD) and those with DKD through continuous glucose monitoring (CGM).

METHODS

We analyzed ambulatory glucose profiles. The primary outcome was time in range (TIR) and the secondary outcomes included hypoglycemia and glucose variability.

RESULTS

Twenty-one patients with ESKD and 42 patients with DKD were enrolled after matching for age and gender. There was no significant difference in TIR between the ESKD and DKD groups. However, patients with ESKD exhibited higher standard deviation (SD), and nocturnal glucose levels compared to those with DKD. For different dialysis treatments, patients undergoing peritoneal dialysis (PD) had higher continuous overlapping net glycemic action (CONGA), J-Index, high blood glucose index (HBGI), glycemic risk assessment in diabetes equation (GRADE), and M-value than those undergoing HD. Additionally, higher all day glycemic values were observed in the PD group. Patients with ESKD on premixed insulin therapy had higher standard deviation of sensor glucose across 24 h and lower nocturnal glucose levels compared with those on Multiple daily injection (MDI).

CONCLUSIONS

Patients with ESKD exhibited higher glucose variability and nocturnal glucose levels compared with those with DKD. Patients receiving PD showed higher glycemic variability and glucose levels compared with those undergoing HD.