Application of an Insulin Analogue in Six Hypoglycemia-Prone Hemodialysis Patients with Type 2 Diabetes.
- Author:
Gyung Eun KIM
1
;
Seong Bin HONG
;
Ju Young HAN
;
Ji Hun JANG
;
Dong Hyuk YANG
;
Seoung Woo LEE
;
Joon Ho SONG
Author Information
1. Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. jhsong@inha.ac.kr
- Publication Type:Case Report
- Keywords:
ESRD;
Glargine;
Hemodialysis, Hypoglycemia;
Insulin analogue
- MeSH:
Dialysis;
Glucose;
Humans;
Hypoglycemia;
Insulin;
Insulin, Long-Acting;
Kidney Failure, Chronic;
Quality of Life;
Renal Dialysis;
Insulin Glargine
- From:Korean Journal of Medicine
2012;83(5):647-653
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Day-to-day insulin requirements often change due to subtle variations in insulin metabolism in patients with type 2 diabetes undergoing hemodialysis. In such cases, intra-hemodialysis hypoglycemia frequently occurs and is a main factor interfering with the delivery of dialysis. As a result, it reduces the quality of life in patients undergoing hemodialysis. The long-acting insulin analogue glargine provides peakless, continuous release over 24 h that approximates a normal basal insulin pattern. Because it has no peak, its use in patients with diabetes undergoing hemodialysis would hypothetically be useful. Specifically, patients would be able to avoid intra-hemodialysis hypoglycemia without the necessity of skipping insulin administration on the day of hemodialysis and achieving adequate glucose control on other days. We recently experienced six cases that switched from treatment with intermediate-acting insulin to a long-acting insulin analogue, which provided better glycemic control by reducing hypoglycemia risk. Limited data are available in the literature concerning insulin analogue usage in patients with diabetes undergoing hemodialysis. Our experience suggests a large-scale prospective investigation is required on this issue.
