Wijewickrama Piyumi, Williams Jennifer, Bain Steve, Dasgupta Indranil, Chowdhury Tahseen A, Wahba Mona, Frankel Andrew H, Lambie Mark, Karalliedde Janaka
Department of Diabetes and Endocrinology, University College London Hospital, London, UK.
Department of Renal Medicine, Royal Devon and Exeter Hospital, Exeter, UK.
Kidney Int Rep. 2023 Feb 9;8(4):700-714. doi: 10.1016/j.ekir.2023.01.040. eCollection 2023 Apr.
There is an increasing number of people with diabetes on peritoneal dialysis (PD) worldwide. However, there is a lack of guidelines and clinical recommendations for managing glucose control in people with diabetes on PD. The aim of this review is to provide a summary of the relevant literature and highlight key clinical considerations with practical aspects in the management of diabetes in people undergoing PD. A formal systematic review was not conducted because of the lack of sufficient and suitable clinical studies. A literature search was performed using PubMed, MEDLINE, Central, Google Scholar and ClinicalTrials.gov., from 1980 through February 2022. The search was limited to publications in English. This narrative review and related guidance have been developed jointly by diabetologists and nephrologists, who reviewed all available current global evidence regarding the management of diabetes in people on PD.We focus on the importance of individualized care for people with diabetes on PD, the burden of hypoglycemia, glycemic variability in the context of PD and treatment choices for optimizing glucose control. In this review, we have summarized the clinical considerations to guide and inform clinicians providing care for people with diabetes on PD.
全球范围内，接受腹膜透析（PD）的糖尿病患者数量日益增加。然而，对于接受PD治疗的糖尿病患者的血糖控制管理，缺乏相关指南和临床建议。本综述的目的是总结相关文献，并强调在接受PD治疗的糖尿病患者管理中具有实际意义的关键临床考量因素。由于缺乏足够且合适的临床研究，未进行正式的系统综述。使用PubMed、MEDLINE、Central、谷歌学术和ClinicalTrials.gov.进行了文献检索，时间跨度从1980年至2022年2月。检索仅限于英文出版物。本叙述性综述及相关指南由糖尿病专家和肾病专家联合制定，他们审查了所有关于接受PD治疗的糖尿病患者管理的现有全球证据。我们关注接受PD治疗的糖尿病患者个体化护理的重要性、低血糖负担、PD背景下的血糖变异性以及优化血糖控制的治疗选择。在本综述中，我们总结了临床考量因素，以指导并告知为接受PD治疗的糖尿病患者提供护理的临床医生。
