Glycemic control in patients with diabetes mellitus on hemodialysis


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Abstract

Achievement of stabilization of carbohydrate metabolism in patients with diabetes mellitus, receiving renal replacement therapy with hemodialysis, is a significant problem in endocrinology. It has to do with multiple factors of this cohort of patients, which affect the level of glycemia, pharmacokinetic of drugs, the efficiency of glycemic control. At the moment, the most efficiency method of glycemic control in patients with type 2 diabetes mellitus on hemodialysis is insulin therapy in the basis - bolus regime by analogues of human insulin. The use of oral hypoglycemic agents is significantly limited. The hemoglobin A1c (HbA1c) remains the main parameter of glycemic control. The simultaneous use of continuous glucose monitoring allows to reveal the true level of glucose of the blood and to carry out the timely correction of therapy in order to achieve targets for glycemic control and to decrease the risk of hypoglycemic episodes. At the moment other glycemic control markers such as glycated albumin and fructosamine are described. However, in routine practice at the moment these indicators are not used due to the lack of sufficient evidentiary base of their use in this cohort of patients.

About the authors

K G Lobanova

Endocrinology Research Centre

Email: miss.sapog@mail.ru
клинический ординатор; ORCID: 0000-0002-3656-0312 Moscow, Russia

A S Severina

Endocrinology Research Centre

к.м.н., с.н.с., врач-эндокринолог отд-ния диабетической болезни почек и посттрансплантационной реабилитации Института диабета «НМИЦ эндокринологии» Moscow, Russia

S A Martinov

Endocrinology Research Centre

д.м.н., в.н.с., врач-нефролог, зав. кабинетом экстракорпоральных методов лечения почечной патологии «НМИЦ эндокринологии» Moscow, Russia

M Sh Shamkhalova

Endocrinology Research Centre

д.м.н., зав. отд-нием диабетической болезни почек и посттрансплантационной реабилитации Института диабета «НМИЦ эндокринологии» Moscow, Russia

M V Shestakova

Endocrinology Research Centre

д.м.н., проф., академик РАН, директор ФГБУ «НМИЦ эндокринологии», директор Института диабета ФГБУ «НМИЦ эндокринологии» Moscow, Russia

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