Chulalongkorn Medical Journal


Background : Glucose dynamics in patients on peritoneal dialysis (PD) is influencedby many factors.Objectives We evaluated the dynamics of interstitial fluid (ISF) glucose in diabeticpatients undergoing PD, controlled for caloric food intake, daily activities,and hypoglycemic agents.Methods : We studied all type-2 diabetic patients at the PD clinic of KingChulalongkorn Memorial Hospital between 2007 and 2008. They received1.5% or 4.25% glucose during continuous ambulatory peritoneal dialysis(CAPD 1.5% or 4.25%), or 1.5% glucose continuous cycling peritonealdialysis (CCPD 1.5%). Continuous glucose monitoring system andfinger-stick were used to assess ISF and blood glucose levels for72 hours, respectively. Sixteen patients (9 CAPD and 7 CCPD) wereassessed.Results : Median age, diabetes onset, and years on PD were 71, 17, and 1.5 years,respectively. There was strong correlation between ISF and blood glucoselevel (r = 0.937). The mean ISF glucose levels between dialysate andnon-dialysate days were not significantly different (P = 0.08) in spite ofhigher total caloric intake on dialysate day (P = 0.049). However, inthe CAPD 4.25% group, mean ISF glucose and total consumed calorieswere significantly higher on dialysate than non-dialysate day (P = 0.026and 0.031, respectively). The difference disappeared after adjustmentfor food calories. ISF glucose started rising after a 15-minute infusion ofdialysate then sustained till 4 hours with a mean increase of 55%.Conclusions : The evidence suggested that high-glucose peritoneal dialysate canincrease ISF glucose but the effect is confounded by food caloric intake.


Faculty of Medicine, Chulalongkorn University

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