Diabetes technology in people with diabetes and advanced chronic kidney disease.

IF 8.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetologia Pub Date : 2024-10-01 Epub Date: 2024-08-08 DOI:10.1007/s00125-024-06244-y
Rodolfo J Galindo, Diana Soliman, Daniel Cherñavvsky, Connie M Rhee
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Abstract

Diabetes is the leading cause and a common comorbidity of advanced chronic kidney disease. Glycaemic management in this population is challenging and characterised by frequent excursions of hypoglycaemia and hyperglycaemia. Current glucose monitoring tools, such as HbA1c, fructosamine and glycated albumin, have biases in this population and provide information only on mean glucose exposure. Revolutionary developments in glucose sensing and insulin delivery technology have occurred in the last decade. Newer factory-calibrated continuous glucose monitors provide real-time glucose data, with predictive alarms, allowing improved assessment of glucose excursions and preventive measures, particularly during and between dialysis sessions. Furthermore, integration of continuous glucose monitors and their predictive alerts with automated insulin delivery systems enables insulin administration to be decreased or stopped proactively, leading to improved glycaemic management and diminishing glycaemic fluctuations. While awaiting regulatory approval, emerging studies, expert real-world experience and clinical guidelines support the use of diabetes technology devices in people with diabetes and advanced chronic kidney disease.

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糖尿病和晚期慢性肾病患者的糖尿病技术。
糖尿病是晚期慢性肾病的主要病因和常见并发症。这类人群的血糖管理具有挑战性,其特点是经常出现低血糖和高血糖。目前的血糖监测工具,如 HbA1c、果糖胺和糖化白蛋白,在这类人群中存在偏差,只能提供平均血糖暴露量的信息。过去十年间,葡萄糖传感和胰岛素输送技术取得了革命性的发展。较新的出厂校准连续血糖监测仪可提供实时血糖数据和预测警报,从而改进了对血糖偏移的评估和预防措施,尤其是在透析期间和透析间歇期。此外,将连续血糖监测仪及其预测警报与胰岛素自动给药系统集成,可主动减少或停止胰岛素给药,从而改善血糖管理并减少血糖波动。在等待监管部门批准的同时,新的研究、专家的实际经验和临床指南都支持在糖尿病和晚期慢性肾病患者中使用糖尿病技术设备。
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来源期刊
Diabetologia
Diabetologia 医学-内分泌学与代谢
CiteScore
18.10
自引率
2.40%
发文量
193
审稿时长
1 months
期刊介绍: Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.
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