Blood Glucose Fluctuation and its Influencing Factors in Patients with Type 2 Diabetes Mellitus and Chronic Renal Insufficiency during Hemodialysis

DU Wei; CHEN Weihong; CHEN Ping; SHEN Xinru; AI Fangli; HE Liangjun

doi:10.3639/j.issn.2095-3097.2025.05.019

Abstract：Objective To explore blood glucose fluctuation and its influencing factors in patients with type 2 diabe-tes mellitus(T2DM)and chronic renal failure(CRF)during hemodialysis(HD).Methods A total of 98 patients with T2DM and CRF who underwent HD in Maanshan People's Hospital were enrolled as the research objects between January 2021 and June 2024.The blood glucose data(24 measurements)within 3 months of regular treatment were collected to calculate blood glucose fluctuation indexes[standard deviation of blood glucose(SDBG),mean amplitude of glycemic excursion(MAGE),large amplitude of glycemic excursion(LAGE)],and blood glucose fluctuation during HD was analyzed.According to the rel-evant guidelines,patients were divided into blood glucose fluctuation group and blood glucose stability group.The influenc-ing factors of blood glucose fluctuation were analyzed by univariate and multivariate Logistic regression analysis.Results In the 98 patients during HD,SDBG,MAGE and LAGE were(2.58±1.16)mmol/L,(4.92±1.47)mmol/L and(6.21±2.98)mmol/L,respectively.There were 54 patients[55.10%(54/98)]with blood glucose fluctuation during HD.According to blood glucose status,patients were divided into blood glucose fluctuation group(n=54)and blood glucose stability group(n=44).Proportions of hypertension history,anxiety/depression,sleep disorders and poor self-management ability,course of DM,insulin dosage on dialysis day,glycosylated hemoglobin and microalbuminuria(mALb)in blood glucose fluctuation group were higher than those in blood glucose stability group,while level of calcium(Ca)and parathyroid hormone(PTH)were lower than those in blood glucose stability group(P<0.05).The results of multivariate logistic regression analysis showed that hypertension history,anxiety/depression,self-management ability and mALb were influencing factors of blood glucose fluctuation in patients with T2DM and CRF during HD(P<0.05).Conclusion The incidence of blood glucose fluctuation is high in patients with T2DM and CRF during HD.The influencing factors of blood glucose fluctuation include hypertension history,anxiety/depression,poor self-management ability and mALb level.