Performance of an interstitial glucose monitoring in patients with type 1 diabetes during haemodialysis

Abstract

Abstract Background The use of interstitial glucose monitoring devices such as Flash Glucose Monitoring has been shown to be beneficial in patients with type 1 diabetes (T1DM). However, these devices have been little studied in patients with diabetes treated by chronic haemodialysis (HD). Methods The goal of this prospective, observational, multicentric, study was to evaluate the analytical performance of the FreeStyle Libre® 2 (FSL2) sensor in T1DM patients during HD sessions. During three HD sessions, interstitial glucose concentrations (ISFG) given by the FSL2 were compared, every 15 minutes, with blood glucose concentration (BG) obtained simultaneously. BG concentrations were measured by two different glucometers: the Accu-Chek Guide® and the StatStrip® meter. Results Twelve hemodialysis patients were included. Mean age was 54 ± 11 years. Mean diabetes duration was 36.5 ± 11.6 years and dialysis vintage was 35 ± 22 months. A total of 565 pairs of ISFG/BG values were available for analysis. The mean absolute relative difference, defined as the mean of the absolute relative differences between the ISFG and BG measurements, was 17.4% and 20.9% when the ISFG were compared to the StatStrip glucometer or Accu-Chek Guide, respectively. Interstitial results tend to underestimate blood results but all values were classified as having clinically acceptable error. The differences observed remained stable during the dialysis session and were not associated with the ultrafiltration rate. Conclusion The use of the FSL2 interstitial glucose monitoring device in HD patients with T1DM is clinically acceptable, even though the accuracy of the device is generally poorer than in studies including non-dialysis patients.