Regulatory effects of different administration strategies of 50％glucose injection on glycemic homeostasis in elderly hemodialysis patients

Tang Xia; Chen Hongyu; Wang Shaoqing; Yao Peng; Yang Bo; Hou Fei; Wu Zhanghong

doi:10.11986/j.issn.1673-873X.2025.11.15

Abstract：Objective To explore the effects of different administration strategies of 50％glucose injection on blood glucose during dialysis with glucose-free dialysate in elderly hemodialysis patients,and to identify an appropriate administration method to prevent intradialytic hypoglycemia in this population.Methods Thirty regularly hemodialyzed patients treated at our center through December 2023 were enrolled.During dialysis,each patient successively received the following three in-terventions(each with 20 g of 50％glucose):oral administration(oral high-glucose group),intravenous injection(Ⅳ high-glucose group),and micro-pump infusion(micro-pump high-glucose group).These were compared with a control condition of ad libitum oral intake during dialysis(control group)in a within-subject before-after design.A mixed-effects model was used to analyze the effects of different 50％glucose administration strategies on the incidence of intradialytic hypoglycemia,incidence of intradialytic hypotension,and blood glucose levels.Results After adjustment for dialysis mode,age,sex,body mass index(BMI),dry weight,primary disease,and dialysis duration,the Ⅳ high-glucose group,oral high-glucose group,and micro-pump high-glucose group all had significantly lower incidence of hypoglycemia compared with the control group(P＜0.05);the micro-pump high-glucose group additionally had a significantly lower incidence of hypotension(P＜0.05).Mixed-effects model analysis showed that,after adjustment for dialysis mode,age,sex,BMI,dry weight,and dialysis dura-tion,patients whose primary disease was diabetic nephropathy had lower blood glucose levels across the observation period.Compared with the control group,the estimated regression coefficients for the effect on blood glucose were 0.289 for the o-ral high-glucose group,0.160 for the Ⅳ high-glucose group,and 0.213 for the micro-pump high-glucose group,with differences being statistically significant(P＜0.05).Conclusion Oral,intravenously injected,and micro-pump infusion of 50％glucose during dialysis with glucose-free dialysate all decrease the incidence of intradialytic hypoglycemia in elderly he-modialysis patients;micro-pump infusion also reduces the incidence of intradialytic hypotension.Over the observation peri-od,oral administration produced the largest effect on blood glucose.