Variability in magnitude and direction of discordance between continuous glucose monitoring (CGM) metrics and traditional biomarkers in patients with diabetes and end-stage kidney disease (ESKD): A case series.
Yunyao Lin, James Ling, Risa Ozaki et al.
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Case in brief
Four patients with diabetes and end-stage kidney disease exhibited significant discordance between glycated hemoglobin A1c (HbA1c) and continuous glucose monitoring (CGM) metrics. The discordance varied over time, with differences ranging from -2.1% to +6.2%. Factors such as anemia and glycemic variability influenced these discrepancies, highlighting the importance of CGM in managing glucose levels in this population.
Diagnostic / clinical pearl
Clinicians should be aware that HbA1c may not accurately reflect glycemic control in patients with end-stage kidney disease, and CGM metrics may provide a more reliable assessment.
Why it matters
Understanding the limitations of traditional biomarkers like HbA1c in this patient group can lead to better management strategies and improved patient outcomes.