Glycemic variability among type 2 diabetes patients with chronic kidney disease (CKD) using continuous glucose monitoring: a study from a tertiary care hospital

Abstract

This study was designed to study the short term oscillations of glucose levels for a period of 3 days by using continuous glucose monitoring (CGM) as it uses glucose as a more important clinical tool, for a more definitive understanding of glycemic variability and its role in diabetic individuals with CKD and thus foreseeing the complications and its better management among high risk individuals. Materials & Methods: Diabetic individuals > 18 years with chronic kidney disease attending outpatient and inpatient of SRI DEVARAJ MEDICAL COLLEGE and RL JALAPPA Hospital. Study Duration: 3 months. Study design: Hospital based observational study. Inclusion criteria: Adults with Type 2 Diabetes Mellitus and Diagnosed with CKD (Either Kidney damage or GFR<60ml/min/ 1.73m2 for ≥ 3 Months - NKF KDIOQI guidelines).Exclusion criteria: Adults with Diagnosed primary kidney diseases, Congenital/ Acquired anatomical defects of the kidney, Obstructive nephropathies, Pregnancy and lactation. Sampling method: Purposive sampling, Sample size: - 50 subjects Results: In our study 78% of the subjects were male and 22% of the subjects were female. In our study 94% of the subjects had hypertension, 46% of the subjects had CAD and 12% of the subjects had strokes. Multiple co-morbidities was present around 44% of the subjects. Similar finding was present in our study majority of the subjects had stage 4 CKD. In our study 46% were overweight, 22% of the subjects were in obesity class 1, 14% of the subjects were in obesity class 2 and only 18% of the subjects had normal weight. Discussion: In our study MODD estimation of inter-day glucose variability which was significantly higher in CKD stage 4, 5 when compared with CKD stage 1, 2, 3. Inter day glucose variability increases as the CKD stage increases similar to a study done Cristina et al.