The Use of HbA1c, Glycated Albumin and Continuous Glucose Monitoring to Assess Glucose Control in the Chronic Kidney Disease Population including Dialysis
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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The Use of HbA1c, Glycated Albumin and Continuous Glucose Monitoring to Assess Glucose Control in the Chronic Kidney Disease Population including Dialysis. / Bomholt, Tobias; Adrian, Therese; Nørgaard, Kirsten; Ranjan, Ajenthen G.; Almdal, Thomas; Larsson, Anders; Vadstrup, Mette; Rix, Marianne; Feldt-Rasmussen, Bo; Hornum, Mads.
I: Nephron, Bind 145, Nr. 1, 2021, s. 14-19.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - The Use of HbA1c, Glycated Albumin and Continuous Glucose Monitoring to Assess Glucose Control in the Chronic Kidney Disease Population including Dialysis
AU - Bomholt, Tobias
AU - Adrian, Therese
AU - Nørgaard, Kirsten
AU - Ranjan, Ajenthen G.
AU - Almdal, Thomas
AU - Larsson, Anders
AU - Vadstrup, Mette
AU - Rix, Marianne
AU - Feldt-Rasmussen, Bo
AU - Hornum, Mads
PY - 2021
Y1 - 2021
N2 - Background: Glycated haemoglobin A1c (HbA1c) has limitations as a glycemic marker for patients with diabetes and CKD and for those receiving dialysis. Glycated albumin is an alternative glycemic marker, and some studies have found that glycated albumin more accurately reflects glycemic control than HbA1c in these groups. However, several factors are known to influence the value of glycated albumin including proteinuria. Continuous glucose monitoring (CGM) is another alternative to HbA1c. CGM allows one to assess mean glucose, glucose variability, and the time spent in hypo-, normo-, and hyperglycemia. Currently, several different CGM models are approved for use in patients receiving dialysis; CKD (not on dialysis) is not a contraindication in any of these models. Some devices are for blind recording, while others provide real-time data to patients. Small studies suggest that CGM could improve glycemic control in hemodialysis patients, but this has not been studied for individual CKD stages. Summary: Glycated albumin and CGM avoid the pitfalls of HbA1c in CKD and dialysis populations. However, the value of glycated albumin may be affected by several factors. CGM provides a precise estimation of the mean glucose. Here, we discuss the strengths and limitations for using HbA1c, glycated albumin, or CGM in CKD and dialysis population. Key Messages: Glycated albumin is an alternative glycemic marker but is affected by proteinuria. CGM provides a precise estimation of mean glucose and glucose variability. It remains unclear if CGM improves glycemic control in the CKD and dialysis populations.
AB - Background: Glycated haemoglobin A1c (HbA1c) has limitations as a glycemic marker for patients with diabetes and CKD and for those receiving dialysis. Glycated albumin is an alternative glycemic marker, and some studies have found that glycated albumin more accurately reflects glycemic control than HbA1c in these groups. However, several factors are known to influence the value of glycated albumin including proteinuria. Continuous glucose monitoring (CGM) is another alternative to HbA1c. CGM allows one to assess mean glucose, glucose variability, and the time spent in hypo-, normo-, and hyperglycemia. Currently, several different CGM models are approved for use in patients receiving dialysis; CKD (not on dialysis) is not a contraindication in any of these models. Some devices are for blind recording, while others provide real-time data to patients. Small studies suggest that CGM could improve glycemic control in hemodialysis patients, but this has not been studied for individual CKD stages. Summary: Glycated albumin and CGM avoid the pitfalls of HbA1c in CKD and dialysis populations. However, the value of glycated albumin may be affected by several factors. CGM provides a precise estimation of the mean glucose. Here, we discuss the strengths and limitations for using HbA1c, glycated albumin, or CGM in CKD and dialysis population. Key Messages: Glycated albumin is an alternative glycemic marker but is affected by proteinuria. CGM provides a precise estimation of mean glucose and glucose variability. It remains unclear if CGM improves glycemic control in the CKD and dialysis populations.
KW - Chronic kidney disease
KW - Continuous glucose monitoring
KW - Diabetes
KW - Dialysis
KW - Glycated albumin
U2 - 10.1159/000511614
DO - 10.1159/000511614
M3 - Review
C2 - 33264783
AN - SCOPUS:85097385249
VL - 145
SP - 14
EP - 19
JO - Nephron - Clinical Practice
JF - Nephron - Clinical Practice
SN - 1660-8151
IS - 1
ER -
ID: 255354747