Background: The overall increase in the number of people with diabetes mellitus has a major impact on the increasing number of patients with diabetic kidney disease (DKD). Hypoglycemia that is brought about by altered glucose homeostasis and the hemodialysis process in patients with DKD poses a great challenge to clinicians in achieving blood glucose control. This study has been undertaken to evaluate the prevalence of hypoglycemia among diabetics undergoing hemodialysis and determine the clinical factors predicting the development of hypoglycemia.
Methods: We conducted a prospective, cross-sectional study that included 75 patients with diabetes mellitus undergoing maintenance hemodialysis at the University of Santo Tomas Hospital, Center for Kidney Disease. The patients’ predialysis and hourly intradialytic serum glucose levels were measured until the end of the session. Hypoglycemia was considered as a blood glucose ≤70 mg/dL with/without symptoms.
Results: Elderly patients and in-hospital patients tend to develop hypoglycemia with a p-value of 0.0028 and 0.001, respectively. Old age (p-value 0.0093), female sex (p-value 0.0224), hypertension (p-value 0.0301), CAD (p-value 0.0058), frequency of hemodialysis (p-value 0.0000), no caloric intake during the dialysis session (p-value 0.0022) and admission (p-value 0.0007) predicted hypoglycemia in our study.
Conclusions: In conclusion, the prevalence of hypoglycemia among patients with type 2 diabetes mellitus undergoing maintenance hemodialysis in our setting is 12%. There is an increased rate of hypoglycemia amongst the elderly as well as admitted patients. Our results identified old age, presence of CAD, increased frequency of hemodialysis and hospital admission as the predictors of hypoglycemia.
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