Times in range and nutrition of individuals on hemodialysis and diabetes

Abstract

Individuals with diabetes and hemodialysis present a challenge in metabolic control and nutritional adjustment with high nutrient demand. Traditional blood glucose measurement controls, such as self-monitoring, glycated hemoglobin (A1C), and fructosamine, remain uncertain as they do not present the entire picture of glycemic incursions. This review seeks to collect evidence on the efficacy of continuous glucose monitoring, nutritional adjustment, and adequate metabolic control in people with diabetes and hemodialysis. Currently, continuous glucose monitoring plays an essential role in the metabolic control of these individuals, as well as in glycemic variability. No individual standard is exclusive to these conditions concerning the values of the times in range. However, the American Diabetes Association does allow the identification of the average values for high-risk populations and comorbidities associated with diabetes, such as kidney disease. Synchronous metabolic control and nutritional monitoring go hand in hand in people with diabetes and hemodialysis, this being a pillar in comprehensive management to reduce complications and improve the quality of life of these individuals.