| Theme |
Glycemic Control and Diabetes with Chronic Kidney Disease |
| Title |
Utility of glycoalbumin as a glycemic marker in diabetic hemodialysis patients |
| Author |
Masaaki Inaba |
Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine |
| [ Summary ] |
Although strict glycemic control also has favorable effects on cardiovascular disease (CVD) in diabetes mellitus (DM) patients, it is not clear in DM hemodialysis patients who are often complicated with severe cardiovascular diseases. There have been several well-designed studies of the impact of glycemic control on the prognosis of DM hemodialysis patients, but most have used glycated hemoglobin (HbA1c) as a marker for glycemic control. HbA1c can be reduced independently of glycemic control and is inversely correlated with the weekly dose of erythropoietin injection. Thus we and others have proposed glycoalbumin (GA) as a better index of glycemic control in DM hemodialysis patients. We have recently reported that DM hemodialysis patients with their GA values less than 20 % showed a significantly lower mortality rate than those with GA values more than 20 %, when the patients analyzed were restricted to those without pre-existing cardiovascular diseases.
These data demonstrated that better glycemic control might improve mortality rate in DM patients even in hemodialysis stage, particularly in those without pre-existing cardiovascular diseases, and that GA might provide a better marker for glycemic control in DM hemodialysis patients. |