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The Use of HbA1c, Glycated Albumin and Continuous Glucose Monitoring to Assess Glucose Control in the Chronic Kidney Disease Population Including Dialysis

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@article{f5555869ac30442bb7b597d8f2326e67,
title = "The Use of HbA1c, Glycated Albumin and Continuous Glucose Monitoring to Assess Glucose Control in the Chronic Kidney Disease Population Including Dialysis",
abstract = "BACKGROUND: Glycated haemoglobin A1c (HbA1c) has limitations as a glycemic marker for patients with diabetes and CKD and for those receiving dialysis. Glycated albumin is an alternative glycemic marker, and some studies have found that glycated albumin more accurately reflects glycemic control than HbA1c in these groups. However, several factors are known to influence the value of glycated albumin including proteinuria. Continuous glucose monitoring (CGM) is another alternative to HbA1c. CGM allows one to assess mean glucose, glucose variability, and the time spent in hypo-, normo-, and hyperglycemia. Currently, several different CGM models are approved for use in patients receiving dialysis; CKD (not on dialysis) is not a contraindication in any of these models. Some devices are for blind recording, while others provide real-time data to patients. Small studies suggest that CGM could improve glycemic control in hemodialysis patients, but this has not been studied for individual CKD stages.SUMMARY: Glycated albumin and CGM avoid the pitfalls of HbA1c in CKD and dialysis populations. However, the value of glycated albumin may be affected by several factors. CGM provides a precise estimation of the mean glucose. Here, we discuss the strengths and limitations for using HbA1c, glycated albumin, or CGM in CKD and dialysis population. Key Messages: Glycated albumin is an alternative glycemic marker but is affected by proteinuria. CGM provides a precise estimation of mean glucose and glucose variability. It remains unclear if CGM improves glycemic control in the CKD and dialysis populations.",
keywords = "Chronic kidney disease, Continuous glucose monitoring, Diabetes, Dialysis, Glycated albumin",
author = "Tobias Bomholt and Therese Adrian and Kirsten N{\o}rgaard and Ranjan, {Ajenthen G} and Thomas Almdal and Anders Larsson and Mette Vadstrup and Marianne Rix and Bo Feldt-Rasmussen and Mads Hornum",
note = "{\textcopyright} 2020 S. Karger AG, Basel.",
year = "2021",
month = jan,
doi = "10.1159/000511614",
language = "English",
volume = "145",
pages = "14--19",
journal = "Experimental Nephrology",
issn = "0028-2766",
publisher = "S./Karger AG",
number = "1",

}

RIS

TY - JOUR

T1 - The Use of HbA1c, Glycated Albumin and Continuous Glucose Monitoring to Assess Glucose Control in the Chronic Kidney Disease Population Including Dialysis

AU - Bomholt, Tobias

AU - Adrian, Therese

AU - Nørgaard, Kirsten

AU - Ranjan, Ajenthen G

AU - Almdal, Thomas

AU - Larsson, Anders

AU - Vadstrup, Mette

AU - Rix, Marianne

AU - Feldt-Rasmussen, Bo

AU - Hornum, Mads

N1 - © 2020 S. Karger AG, Basel.

PY - 2021/1

Y1 - 2021/1

N2 - BACKGROUND: Glycated haemoglobin A1c (HbA1c) has limitations as a glycemic marker for patients with diabetes and CKD and for those receiving dialysis. Glycated albumin is an alternative glycemic marker, and some studies have found that glycated albumin more accurately reflects glycemic control than HbA1c in these groups. However, several factors are known to influence the value of glycated albumin including proteinuria. Continuous glucose monitoring (CGM) is another alternative to HbA1c. CGM allows one to assess mean glucose, glucose variability, and the time spent in hypo-, normo-, and hyperglycemia. Currently, several different CGM models are approved for use in patients receiving dialysis; CKD (not on dialysis) is not a contraindication in any of these models. Some devices are for blind recording, while others provide real-time data to patients. Small studies suggest that CGM could improve glycemic control in hemodialysis patients, but this has not been studied for individual CKD stages.SUMMARY: Glycated albumin and CGM avoid the pitfalls of HbA1c in CKD and dialysis populations. However, the value of glycated albumin may be affected by several factors. CGM provides a precise estimation of the mean glucose. Here, we discuss the strengths and limitations for using HbA1c, glycated albumin, or CGM in CKD and dialysis population. Key Messages: Glycated albumin is an alternative glycemic marker but is affected by proteinuria. CGM provides a precise estimation of mean glucose and glucose variability. It remains unclear if CGM improves glycemic control in the CKD and dialysis populations.

AB - BACKGROUND: Glycated haemoglobin A1c (HbA1c) has limitations as a glycemic marker for patients with diabetes and CKD and for those receiving dialysis. Glycated albumin is an alternative glycemic marker, and some studies have found that glycated albumin more accurately reflects glycemic control than HbA1c in these groups. However, several factors are known to influence the value of glycated albumin including proteinuria. Continuous glucose monitoring (CGM) is another alternative to HbA1c. CGM allows one to assess mean glucose, glucose variability, and the time spent in hypo-, normo-, and hyperglycemia. Currently, several different CGM models are approved for use in patients receiving dialysis; CKD (not on dialysis) is not a contraindication in any of these models. Some devices are for blind recording, while others provide real-time data to patients. Small studies suggest that CGM could improve glycemic control in hemodialysis patients, but this has not been studied for individual CKD stages.SUMMARY: Glycated albumin and CGM avoid the pitfalls of HbA1c in CKD and dialysis populations. However, the value of glycated albumin may be affected by several factors. CGM provides a precise estimation of the mean glucose. Here, we discuss the strengths and limitations for using HbA1c, glycated albumin, or CGM in CKD and dialysis population. Key Messages: Glycated albumin is an alternative glycemic marker but is affected by proteinuria. CGM provides a precise estimation of mean glucose and glucose variability. It remains unclear if CGM improves glycemic control in the CKD and dialysis populations.

KW - Chronic kidney disease

KW - Continuous glucose monitoring

KW - Diabetes

KW - Dialysis

KW - Glycated albumin

UR - http://www.scopus.com/inward/record.url?scp=85097385249&partnerID=8YFLogxK

U2 - 10.1159/000511614

DO - 10.1159/000511614

M3 - Review

C2 - 33264783

VL - 145

SP - 14

EP - 19

JO - Experimental Nephrology

JF - Experimental Nephrology

SN - 0028-2766

IS - 1

ER -

ID: 61375734