Role of technology in the glucose control of aged patients with diabetes in dialysis

Background and aims: Diabetic patients on dialysis are at an increased risk of cardiovascular diseases and they are normally older than the non-diabetic ones. Aim of this analysis is to evaluate the role of technology in the glycemic control of a diabetic aged population in dialysis. Methods: Multicenter retrospective analysis. Results: One T1D and ten T2D patients (3 females, mean age=63±12 years, median years from diabetes onset=23 and from dialysis start=2) in dialysis (10 hemodialysis and 2 peritoneal) with at least one more comorbidity were evaluated in 4 centers in Calabria region, Italy. To all patients, in MDI and able to manage technology by themselves or by the care giver, was proposed to use technology to manage their diabetes and avoid hypo and hyperglycemia. Six started to use an Advanced Hybrid Close Loop system (MiniMedTM 780G system) and 5 a rt-CGM (in 2 patients the rtCGM was connected to a smart pen, InPenTM). Overall, at 3-month the mean SG was 162 mg/dl, TIR (70-180mg/dl) 69.5%, TBR (<70mg/dl) 0.61% (0% under 54mg/dl), TAR (>180mg/dl) 29.9%, TAR (>250mg/dl) 7.0% and the GMI was 7.2%. Five (62.5%) patients (3 using the AHCL system) reached a GMI<7%, a TIR>70% and a TBR (<70mg/dl) <1%. The percentage of sensor usage was 86%. No severe hypoglycemia events or DKA occurred. Conclusions: The use of technology in aged diabetic patients in dialysis is safe and can help to control glycemia. More studies are needed to validate our initial experience.