Important causes of hypoglycaemia in patients with diabetes on peritoneal dialysis

Mehmet, S.; Quan, Gao; Thomas, Stephen; Goldsmith, David

doi:10.1046/j.0742-3071.2001.00556.x

Cited by 50 publications

(17 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In particular, the marked response to maltose is serious, because the infusion solution for diabetes contains a high concentration of maltose. 9) Moreover, sPQQ-GDH lacks thermal stability, although some attempts have been made to improve the substrate specificity and thermal stability of sPQQ-GDH by protein engineering. 10) The other type of dehydrogenase is nicotinamide y To whom correspondence should be addressed.…”

Section: àmentioning

confidence: 99%

Novel FAD-Dependent Glucose Dehydrogenase for a Dioxygen-Insensitive Glucose Biosensor

Tsujimura

Kojima

Kano

et al. 2006

Bioscience, Biotechnology, and Biochemistry

157

111

View full text Add to dashboard Cite

Section: àmentioning

confidence: 99%

Novel FAD-Dependent Glucose Dehydrogenase for a Dioxygen-Insensitive Glucose Biosensor

Tsujimura

Kojima

Kano

et al. 2006

Bioscience, Biotechnology, and Biochemistry

157

111

View full text Add to dashboard Cite

“…In a subsequent study on whole blood, the error did not occur with analyzers that measured glucose by using hexose kinase enzymes or those that used glucose oxidase enzymes [2]. Diabetic patients using icodextrin containing peritoneal dialysis fluid have had falsely elevated glucose readings [4][5][6] Icodextrin, a polymer of glucose, is used in peritoneal dialysis as an osmotic agent to facilitate fluid movement across membranes. When used for this purpose, icodextrin may be absorbed by the lymphatic system, and then subsequently hydrolyzed to glucose oligomers such as maltose, maltriose and maltotetraose [4].…”

Section: Discussionmentioning

confidence: 99%

Unrecognized hypoglycemia due to maltodextrin interference with bedside glucometry

2009

View full text Add to dashboard Cite

Introduction: Glucometry is widely used to confirm or exclude hypoglycemia in patients with suggestive clinical findings. Nonglucose sugars may be detected by certain types of glucometers, causing false elevation of the glucometer analysis of the blood sugar. Since these other sugars are not functionally glucose and may even induce excess insulin release, clinical hypoglycemia may be missed.Case Report: We report a 79-year-old man on enteral feeds containing maltodextrin, a glucose polymer, who had persistently high glucometer-measured blood glucose despite normal blood glucose measured by formal laboratory analysis.Discussion: Excess insulin administration, based on the erroneous glucometer reading, may have caused unrecognized fatal clinical hypoglycemia. This has been reported following intravenous administration of related nonglucose sugars but not with enteral maltodextrin. Further study is required to confirm the effects of maltodextrin on glucometry.Conclusion: False elevation of blood glucose measured on certain point-of-care glucometers can occur following the oral administration of maltodextrin. Toxicology Observations

show abstract

“…The extent of these episodes of hyperglycaemia is significantly higher in diabetic subjects with high peritoneal transport states as compared to high-average states. Using minimally glycaemic solution mixtures has been shown to reduce mean glucose concentrations without an excess of hypoglycaemic episodes 54. There is, however, a significant challenge among patients with poor glycaemic control on PD.…”

Section: Challenges In Management Of Hyperglycaemia In Patients On DImentioning

confidence: 99%

Managing diabetes in dialysis patients

O'Toole¹,

Fan²,

Yaqoob³

et al. 2012

Postgraduate Medical Journal

View full text Add to dashboard Cite

Burgeoning levels of diabetes are a major concern for dialysis services, as diabetes is now the most common cause of end-stage renal disease in most developed nations. With the rapid rise in diabetes prevalence in developing countries, the burden of end stage renal failure due to diabetes is also expected to rise in such countries. Diabetic patients on dialysis have a high burden of morbidity and mortality, particularly from cardiovascular disease, and a higher societal and economic cost compared to non-diabetic subjects on dialysis. Tight glycaemic and blood pressure control in diabetic patients has an important impact in reducing risk of progression to end stage renal disease. The evidence for improving glycaemic control in patients on dialysis having an impact on mortality or morbidity is sparse. Indeed, many factors make improving glycaemic control in patients on dialysis very challenging, including therapeutic difficulties with hypoglycaemic agents, monitoring difficulties, dialysis strategies that exacerbate hyperglycaemia or hypoglycaemia, and possibly a degree of therapeutic nihilism or inertia on the part of clinical diabetologists and nephrologists. Standard drug therapy for hyperglycaemia (eg, metformin) is clearly not possible in patients on dialysis. Thus, sulphonylureas and insulin have been the mainstay of treatment. Newer therapies for hyperglycaemia, such as gliptins and glucagon-like peptide-1 analogues have become available, but until recently, renal failure has precluded their use. Newer gliptins, however, are now licensed for use in 'severe renal failure', although they have yet to be trialled in dialysis patients. Diabetic patients on dialysis have special needs, as they have a much greater burden of complications (cardiac, retinal and foot). They may be best managed in a multidisciplinary diabetic-renal clinic setting, using the skills of diabetologists, nephrologists, clinical nurse specialists in nephrology and diabetes, along with dietitians and podiatrists.

show abstract

Important causes of hypoglycaemia in patients with diabetes on peritoneal dialysis

Abstract: Careful teamwork between diabetes and renal physicians and specialist nurses is highly desirable to achieve good glucose control in a group of patients at particular risk of microvascular and macrovascular complications.

Cited by 50 publications

References 15 publications

Novel FAD-Dependent Glucose Dehydrogenase for a Dioxygen-Insensitive Glucose Biosensor

Novel FAD-Dependent Glucose Dehydrogenase for a Dioxygen-Insensitive Glucose Biosensor

Unrecognized hypoglycemia due to maltodextrin interference with bedside glucometry

Managing diabetes in dialysis patients

Contact Info

Product

Resources

About