Author: Dr Sufyan Hussain and Dr Andrew Frankel
People with diabetes on haemodialysis represent a complex group that are at high-risk for medical complications including hypoglycaemia. Furthermore, these individuals have historically not received the attention to their glycaemic control that would be required for their long-term health and expected according to guidelines for managing people with diabetes. The glycaemic assessment of individuals on haemodialysis is difficult to interpret owing to inaccuracies in commonly used measures of glycaemia.
The last few years have seen significant advances in technologies that allow continuous glucose monitoring to be performed on individuals with diabetes, allowing improved outcomes and safety, as well as reducing the burden of treatment for people with diabetes.
This joint working group report provides an update of the evidence and technology as well as a detailed consensus with practical recommendations on optimal strategies to assess glycaemia in people with diabetes on haemodialysis. It has been endorsed by the ABCD Renal, ABCD DTN and Renal Association and its implementation will require collaboration between health care teams working within diabetes, primary care and the dialysis unit itself. It presents a clear guidance for healthcare professionals as well as recommendations for system and commissioning leads to adopt into future technology funding considerations for people with diabetes.