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Hypoglycemia in patients on hemodialysis with diabetes mellitus


Authors: Marián Mokáň;  Peter Galajda
Authors place of work: I. interná klinika JLF UK a UNM, Martin
Published in the journal: Forum Diab 2024; 13(3): 119-124
Category: Review Article

Summary

Chronic kidney disease in patients with or without diabetes mellitus is associated with higher risk of hypoglycemia, mainly due to defect of kidney gluconeogenesis and reduction of renal insulin clearance. Hypoglycemia often occurs in patients on hemodialysis. Risk of hypoglycemia in these patients is increased in the case of strict glycemic control during treatment by insulin or oral antidiabetics, using of dialysate solutions without glucose and malnutrition. In prevention of hypoglycemia in hemodialyzed diabetic patients there is recommended using of dialysate solutions with glucose concentration 5.5–11.1 mM/L, individual titration of insulin dose and less strict goals of glycosylated hemoglobin values 7–8 % according to DCCT in the case of repeated hypoglycemias.

Keywords:

hypoglycemia – diabetes mellitus – chronic kidney disease – hemodialysis


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Štítky
Diabetology Endocrinology Internal medicine
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