Abstract
Glycated albumin (GA) has been reported to be a better indicator of glycemic control than hemoglobin A1c (HbA1c) in diabetic hemodialysis (HD) patients. We performed a cross-sectional study to evaluate associations between daily glucose profiles based on blood glucose measurements at seven different times a day and their GA, HbA1c, and pre-dialysis glucose levels in 90 HD patients with (n = 46) and without (n = 44) diabetes. The results of a univariate analysis showed that the GA, HbA1c, and pre-dialaysis glucose levels were significantly correlated with the daily glucose profiles. In a multivariate analysis, the GA levels were found to be independently correlated with maximum glucose levels (F = 9.448, P = 0.0028) and mean amplitude of glucose excursion (MAGE, F = 5.169, P = 0.0255), but no significant correlation was found between the HbA1c levels and daily glucose profiles. The pre-dialysis glucose levels were independently correlated with minimum glucose levels (F = 8.336, P = 0.0049). In a stratified analysis, the identical trend was seen in the diabetic HD patients, but an independent correlation was found only between HbA1c values and mean glucose levels in nondiabetic HD patients. GA levels may be a better indicator of glycemic control than HbA1c and pre-dialysis glucose levels, especially as a means of evaluating the glucose excursions in diabetic HD patients.
Highlights
Glycated albumin (GA) has been reported to be a better indicator of glycemic control than hemoglobin A1c (HbA1c) in diabetic hemodialysis (HD) patients
The results of this study showed significant correlations between the pre-dialysis glucose, HbA1c values, and GA values and their daily glucose profiles in HD patients
GA levels are used as an indicator of short-term glycemic control, because metabolic albumin turnover is faster than hemoglobin turnover; albumin has a lifespan of approximately 17 to 23 days
Summary
Glycated albumin (GA) has been reported to be a better indicator of glycemic control than hemoglobin A1c (HbA1c) in diabetic hemodialysis (HD) patients. Hyperglycemia causes micro- and macroangiopathy in diabetic patients, and better glycemic control prevents diabetic complications [3, 4]. Observational studies that have evaluated the relationship between glycemic control and the survival of HD patients with diabetes have yielded conflicting results [5,6,7]. Using serum glycated hemoglobin (HbA1c) to assess glycemic control in HD patients may result in underestimation of the level. Tsuruta et al Renal Replacement Therapy (2016) 2:3 have been reported to be more useful indicator of glycemic control, especially as a means of evaluating postprandial glycemic excursion than HbA1c in diabetic patients without nephropathy [13]. The aim of this study was to investigate associations between the pre-dialysis glucose, HbA1c, GA levels of HD patients, and their daily glucose profiles
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