Accuracy of Flash Glucose Monitoring in Patients with Diabetes Mellitus on Hemodialysis and Its Relationship with Hydration Status

Background: The use of flash-glucose monitoring system FreeStyle Libre (FSL) has demonstrated benefits in metabolic control and quality of life in different populations with diabetes mellitus (DM), being funded in many countries. Due to this, DM subjects on hemodialysis (HD) are using FSL despite th...

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Bibliographic Details
Published in:	Journal of diabetes science and technology Vol. 15; no. 6; pp. 1308 - 1312
Main Authors:	Genua, Idoia, Sánchez-Hernandez, Joan, Martínez, Maria José, Pujol, Isabel, Places, Jaume, González, Carmen, Martinez, Esther, Díaz, Juan Manuel, Chico, Ana
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01-11-2021
Subjects:	Blood Glucose Blood Glucose Self-Monitoring Diabetes Mellitus, Type 1 Glucose Humans Original Prospective Studies Quality of Life Renal Dialysis hemodialysis Free Style Libre hydration status flash glucose monitoring interstitial glucose
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Summary:	Background: The use of flash-glucose monitoring system FreeStyle Libre (FSL) has demonstrated benefits in metabolic control and quality of life in different populations with diabetes mellitus (DM), being funded in many countries. Due to this, DM subjects on hemodialysis (HD) are using FSL despite the accuracy in this population being unclear. The aims of the present study are to assess the accuracy of FSL in DM subjects on HD, its relationship to hydration status, and patient satisfaction. Material and Methods: A prospective study in 16 patients with DM in a chronic HD program was conducted. Interstitial glucose values from FSL during a 14-day period were compared to capillary glucose measurements obtained at the same time. Hydration status was measured via bioimpedance spectroscopy. Satisfaction with FSL was obtained from an ad hoc satisfaction questionnaire. Results: A total of 766 paired interstitial and capillary glucose levels were analyzed. A correlation coefficient of 0.936 was determined and a mean absolute relative difference (MARD) value of 23%, increasing to 29% during HD. MARD was not related to hydration status. Interstitial glucose values were lower during HD (100.1 ± 17 mg/dL) than within the 12 hours after (125.1 ± 39 mg/dL; P = .012) and the days without HD (134.2 ± 32 mg/dL; P = .001). Subjects showed high satisfaction with FSL. Conclusion: The accuracy of FSL in DM patients on HD is lower than in other populations, especially during HD sessions and is not related with the hydration status. Despite this, the degree of patient satisfaction with FSL is very high.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work
ISSN:	1932-2968 1932-2968 1932-3107
DOI:	10.1177/1932296820975057