Open AccessEffectiveness of Dose Adjustment of Insulin in Type 2 Diabetes among Hemodialysis Patients with End-Stage Renal Disease: A Randomized Crossover Study
Author(s) -
Amol Singhsakul,
Ouppatham Supasyndh,
Bancha Satirapoj
Publication year - 2019
Publication title -
journal of diabetes research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.034
H-Index - 50
eISSN - 2314-6753
pISSN - 2314-6745
DOI - 10.1155/2019/6923543
Subject(s) - medicine , hemodialysis , insulin , hypoglycemia , glycemic , end stage renal disease , dialysis , randomized controlled trial , type 2 diabetes , crossover study , diabetes mellitus , endocrinology , placebo , alternative medicine , pathology
Determining insulin requirements for hemodialysis patients with end-stage renal disease (ESRD) is difficult. We performed a randomized crossover study among type 2 diabetes (T2DM) patients with ESRD on continuous hemodialysis and receiving standard insulin for glycemic control. The patients were randomized in 2 groups: daily insulin needed on the day after hemodialysis and a 25% decrease in daily insulin needed on the day after hemodialysis. A total of 51 T2DM patients with ESRD were enrolled. The adjusted-insulin group had higher plasma glucose levels at the 2nd hour of dialysis than those of the nonadjusted-insulin group. Incidence of hypoglycemia per dialysis session (3.3% vs. 0.7%, P = 0.02) and symptoms related to hypoglycemia (6.9% vs. 0.7%, P = 0.001) were more frequent in the nonadjusted-insulin group. A reduced insulin administration of 25% among T2DM patients undergoing hemodialysis on the day of dialysis was associated with sustained glycemic efficacy and the production of fewer hypoglycemic symptoms. This trial is registered with TCTR20180724002 .