Clinical studies have shown that, regardless of type 1 or type 2 diabetes, the average glycosylated hemoglobin (HbAlc) levels below 7%, the incidence of long-term complications were significantly reduced. Therefore, dialysis patients should be taken to strengthen the treatment of insulin, so that blood sugar remained in a stable state. Dialysis patients should not be controlled HbAlc level is too low, or easy to induce hypoglycemia; also should not be controlled HbAlc level is too high, otherwise the prevalence of hospitalization, mortality increased.
In the impact on DKD glucose metabolism, HD may be more beneficial than PD. First, dialysis can reduce the concentration of plasma insulin to avoid excessive accumulation, long-term dialysis can reduce body weight, remove excess fat, thereby improving insulin resistance, contribute to the normal level of blood glucose regression; Second, the removal of uremic molecules can improve the liver Glycogen gluconeogenesis, can improve the ability of peripheral tissue sugar uptake, help to improve glucose metabolism disorders. The PD treatment of conventional use of peritoneal dialysis fluid, to a certain extent, increased insulin resistance, and bring a new series of metabolic disorders. Therefore, diabetic patients with PD, you must actively control blood sugar.
However, HD and PD based on the pros and cons of sugar metabolism is not absolute. Diabetes hemodialysis patients with hypotension, hypoproteinemia, hemodialysis before the low blood sugar levels, the risk of hypoglycemia higher than PD; PD treatment can also choose sugar-free peritoneal dialysis solution as a penetrant to reduce serum insulin Level, increased insulin sensitivity, which helps to improve glucose metabolism disorders.
