Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok 10400, Thailand.
J Diabetes Res. 2019 Nov 13;2019:6923543. doi: 10.1155/2019/6923543. eCollection 2019.
Determining insulin requirements for hemodialysis patients with end-stage renal disease (ESRD) is difficult. We performed a randomized crossover study among type 2 diabetes (T2DM) patients with ESRD on continuous hemodialysis and receiving standard insulin for glycemic control. The patients were randomized in 2 groups: daily insulin needed on the day after hemodialysis and a 25% decrease in daily insulin needed on the day after hemodialysis. A total of 51 T2DM patients with ESRD were enrolled. The adjusted-insulin group had higher plasma glucose levels at the 2nd hour of dialysis than those of the nonadjusted-insulin group. Incidence of hypoglycemia per dialysis session (3.3% vs. 0.7%, = 0.02) and symptoms related to hypoglycemia (6.9% vs. 0.7%, = 0.001) were more frequent in the nonadjusted-insulin group. A reduced insulin administration of 25% among T2DM patients undergoing hemodialysis on the day of dialysis was associated with sustained glycemic efficacy and the production of fewer hypoglycemic symptoms. This trial is registered with TCTR20180724002.
确定终末期肾病（ESRD）血液透析患者的胰岛素需求很困难。我们在接受标准胰岛素血糖控制的 2 型糖尿病（T2DM）合并 ESRD 持续血液透析患者中进行了一项随机交叉研究。患者随机分为 2 组：透析后第 1 天的每日胰岛素需求量和透析后第 1 天的每日胰岛素需求量减少 25%。共纳入 51 例 T2DM 合并 ESRD 患者。调整胰岛素组在透析的第 2 小时的血浆葡萄糖水平高于未调整胰岛素组。非调整胰岛素组的每透析疗程低血糖发生率（3.3%比 0.7%，=0.02）和低血糖相关症状发生率（6.9%比 0.7%，=0.001）更高。在接受血液透析的 T2DM 患者中，透析日胰岛素用量减少 25%与持续的血糖疗效和更少的低血糖症状相关。该试验在 TCTR20180724002 注册。
