The mean HbA1c- and FBG-values were not significantly different before and after the start of dialysis therapy. The average insulin requirement was 26 +/- 10 IU/day in the predialysis period, 25 +/- 12 IU/day at the start, and 24 +/- 13 as well as 22 +/- 13 IU/day after the start of dialysis. The mean cholesterol level fell significantly from 199 +/- 63 and 190 +/- 49 mg/dL in the predialysis phase to 167 +/- 62 and 157 +/- 38 mg/dL after dialysis began. The triglyceride concentrations decreased only slightly after the start of dialysis. The incidence of hypoglycemia (n/patient/month) was markedly lower in the predialysis phase (0.4 vs. 0.6, NS) than after start of dialysis. In patients with residual diuresis (<500 mL urine/day) the needed insulin doses decreased significantly by 29% compared to patients with higher residual diuresis, whose insulin requirement remained unchanged. In summary, hemodialysis had no significant long-term effect on glycemic control in insulin-treated type 2 diabetic patients, but incidence of hypoglycemia tended to be higher under hemodialysis than in the predialysis period. Lipid levels tended to be lower after the initiation of dialysis therapy. Insulin requirement under hemodialysis decreased only in patients with loss of residual urine volume (below 500 mL urine/day).
The mean HbA1c- and FBG-values were not significantly different before and after the start of dialysis therapy. The average insulin requirement was 26 +/- 10 IU/day in the predialysis period, 25 +/- 12 IU/day at the start, and 24 +/- 13 as well as 22 +/- 13 IU/day after the start of dialysis. The mean cholesterol level fell significantly from 199 +/- 63 and 190 +/- 49 mg/dL in the predialysis phase to 167 +/- 62 and 157 +/- 38 mg/dL after dialysis began. The triglyceride concentrations decreased only slightly after the start of dialysis. The incidence of hypoglycemia (n/patient/month) was markedly lower in the predialysis phase (0.4 vs. 0.6, NS) than after start of dialysis. In patients with residual diuresis (<500 mL urine/day) the needed insulin doses decreased significantly by 29% compared to patients with higher residual diuresis, whose insulin requirement remained unchanged. In summary, hemodialysis had no significant long-term effect on glycemic control in insulin-treated type 2 diabetic patients, but incidence of hypoglycemia tended to be higher under hemodialysis than in the predialysis period. Lipid levels tended to be lower after the initiation of dialysis therapy. Insulin requirement under hemodialysis decreased only in patients with loss of residual urine volume (below 500 mL urine/day).
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