Abstract
Introduction: Glycaemic variability (GV) or glycaemic fluctuations carries a significant higher risk of diabetic-related complications, especially cardiovascular. Extensive researches have been reported, but study on the end-stage-kidney-disease (ESKD) patients on chronic haemodialysis are scarce. This study aims to determine the magnitude of GV among ESKD (diabetic vs non-diabetic) patients and its associated factors during haemodialysis day (HDD) and non-haemodialysis day (NHDD). Methods: We recruited 150 patients on haemodialysis, 93 patients had diabetic (DM-ESKD), and 57 non-diabetic (NDM-ESKD). The GV indices (standard deviation [SD] and percentage co-efficient variant [%CV]) were obtained from 11-point and 7-point self-monitoring blood glucose (SMBG) profiles during haemodialysis and non-haemodialysis day. The GV indices and its associated factors were analysed comparing between both groups during the HDD and NHDD. Results: Mean blood glucose during HDD was 9.33 [SD 2.7, %CV 30.6%] mmol/L in DM-ESKD compared to 6.07 [SD 0.85, %CV 21.3%] mmol/L in NDM-ESKD (p =<0.01). The DM-ESKD group experienced significantly higher GV indices compared to NDM-ESKD; both during haemodialysis and non-haemodialysis day, particularly in the group with HbA1c 8-10% (p= <0.01). Presence of diabetes, older age group, hyperlipidaemia, HbA1c, ferritin levels, and albumin were recognised as factors associated with GV. Conclusion: DM-ESKD patients has high glycaemic variability, especially during the haemodialysis day, therefore increasing their chance to develop future devastating complications. We identified high HbA1c, older age group, presence of hyperlipidaemia, ferritin levels, and albumin as factors associated with GV. Since these groups of patients are vulnerable to CVD mortality, urgent attention is needed to rectify it.