Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Day-to-day variation of insulin requirements of patients with type 2 diabetes and end-stage renal disease undergoing maintenance hemodialysis
Diabetes Care, Volume 33, No. 7, Year 2010
Notification
URL copied to clipboard!
Description
OBJECTIVE - To evaluate day-to-day variations of insulin needs in type 2 diabetic patients with end-stage renal disease (ESRD) on maintenance hemodialysis. RESEARCH DESIGN AND METHODS - We developed a 24-h euglycemic clamp in patients who received an average of 2,200 calories in a standardized three-meal and two-snack regimen per day, adjusted to body size and sex. Intravenous insulin was adjusted every 30 min to achieve 5.5 ± 1.1 mmol/l glycemia over 24 h prehemodialysis, during hemodialysis session, and 24 h posthemodialysis in 10 type 2 diabetic patients, aged 55.7 ± 8.7 years with 11.9 ± 4.5 years diabetes duration, undergoing maintenance hemodialysis for 2.3 ± 2.3 years. Insulin requirements were derived from the dose of insulin administered to maintain euglycemia per period of time and day-to-day comparisons performed. RESULTS - Mean capillary glycemia was 5.5 ± 0.3 mmol/l prehemodialysis and 5.3 ± 0.2 mmol/l posthemodialysis (P = 0.39). Pre- and posthemodialysis areas under the glucose curve were comparable. This was achieved by infusing 23.6 ± 7.7 IU/24 h prehemodialysis vs. 19.9 ± 4.9 IU/24 h posthemodialysis, indicating a 15.3% decrease posthemodialysis (P = 0.09). Basal insulin needs decreased from 0.4 ± 0.1/h prehemodialysis to 0.3 ± 0.1/h posthemodialysis (P = 0.01). Total boluses were decreased by 2.2 ± 3.1 IU (P = 0.15). Changes in blood urea did not correlate with changes in insulin needs (r = 0.1, P = 0.79). CONCLUSIONS - The present study has demonstrated a significant 25% reduction in basal insulin requirements the day after dialysis compared with the day before. No significant change in boluses was observed, and overall the reduction of total insulin requirements was -15% equivalent to -4 IU/day posthemodialysis of marginal statistical significance. © 2010 by the American Diabetes Association.
Authors & Co-Authors
Sobngwi, Eugène
Cameroon, Yaounde
Université de Yaoundé I
Cameroon, Yaounde
Central Hospital of Yaounde Fmbs
United Kingdom, Newcastle
University of Newcastle Upon Tyne, Faculty of Medical Sciences
Enoru, Sostanie Takota
Cameroon, Yaounde
Université de Yaoundé I
Ashuntantang, Gloria Enow
Cameroon, Yaounde
Université de Yaoundé I
Azabji-Kenfack, Marcel
Cameroon, Yaounde
Université de Yaoundé I
Dehayem, Mesmin Yefou
Cameroon, Yaounde
Central Hospital of Yaounde Fmbs
Onana, A. B.Anaba
Cameroon, Yaounde
Université de Yaoundé I
Biwole, Daniel
Cameroon, Yaounde
Université de Yaoundé I
Kaze, François Folefack
Cameroon, Yaounde
Université de Yaoundé I
Gautier, Jean François
France, Paris
Hôpital Saint-louis
Mbanya, J. C.
Cameroon, Yaounde
Université de Yaoundé I
Cameroon, Yaounde
Central Hospital of Yaounde Fmbs
Statistics
Citations: 50
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.2337/dc09-2176
ISSN:
01495992
e-ISSN:
19355548
Research Areas
Noncommunicable Diseases