Accuracy of a Factory-Calibrated Continuous Glucose Monitor in Individuals With Diabetes on Hemodialysis

Objective: Continuous glucose monitoring (CGM) improves diabetes management, but its reliability in individuals on hemodialysis is poorly understood and potentially affected by interstitial and intravascular volume variations.

Methods: We assessed the accuracy of a factory-calibrated CGM, using venous blood glucose measurements (vBGM) during hemodialysis sessions and self-monitoring blood glucose (SMBG) at home.

Results: Twenty participants completed the protocol. The mean absolute relative difference of the CGM was 13.8% and 14.4% when calculated on SMBG (n=684) and on vBGM (n=624), and 98.7% and 100% of values in the Parkes error grid A/B zones, respectively. Throughout 181 days of CGM monitoring, the median time in range (70-180mg/dL) was 38.5% (IQR: 29.3-57.9), with 28.7% (7.8-40.6) of the time >250mg/dL.

Conclusions. The overall performance of a factory-calibrated CGM appears reasonably accurate and clinically relevant for use in practice by individuals on hemodialysis and health professionals to improve diabetes management.