The benefit of a glucose-sparing PD therapy on glycemic control measured by serum fructosamine in diabetic patients in a randomized, controlled trial (IMPENDIA)

Li, Philip K. T., Dorval, Marc, Johnson, David W., Rutherford, Peter, Shutov, Evgeny, Story, Ken and Bargman, Joanne M. (2015) The benefit of a glucose-sparing PD therapy on glycemic control measured by serum fructosamine in diabetic patients in a randomized, controlled trial (IMPENDIA). Nephron, 129 4: 233-240. doi:10.1159/000371554


Author Li, Philip K. T.
Dorval, Marc
Johnson, David W.
Rutherford, Peter
Shutov, Evgeny
Story, Ken
Bargman, Joanne M.
Title The benefit of a glucose-sparing PD therapy on glycemic control measured by serum fructosamine in diabetic patients in a randomized, controlled trial (IMPENDIA)
Journal name Nephron   Check publisher's open access policy
ISSN 1660-8151
1660-2110
Publication date 2015-04
Year available 2015
Sub-type Article (original research)
DOI 10.1159/000371554
Volume 129
Issue 4
Start page 233
End page 240
Total pages 8
Place of publication Basel, Switzerland
Publisher S. Karger AG
Collection year 2016
Language eng
Formatted abstract
Background/Aims: Poor glycemic control can lead to increased morbidity and mortality in peritoneal dialysis (PD) patients. Serum fructosamine may be a more reliable marker of glycemic control than HbA1c in dialysis patients. Methods: We evaluated the effects of a glucose-sparing PD regimen on serum fructosamine. In the multicenter, controlled IMPENDIA trial, eligible diabetic PD patients were randomized (1:1) to a 24-hour combination of a glucose sparing regimen (n = 89) or a glucose-based therapy (n = 91). Serum fructosamine and HbA1c were measured at baseline, 3 months and 6 months; fructosamine measurements were corrected for serum albumin (AlbF). Results: Serum fructosamine decreased from 297 to 253 µmol/l in the glucose-sparing group (95% confidence interval [CI] for the difference, −26 to −68, p < 0.001), and increased from 311 to 314 µmol/l in the glucose-only group (95% CI for the difference, −23 to +19, p = 0.87). The mean difference in change of fructosamine levels between groups at 6 months was 64 µmol/l (95% CI 29-99, p < 0.001). HbA1c decreased versus baseline in both groups (treatment difference 0.3%, p = 0.07). The correlation between AlbF and baseline fasting serum glucose was stronger than that seen between HbA1c and baseline fasting serum glucose (r = 0.47, p < 0.0001 and r = 0.31, p < 0.0001, respectively). Conclusion: A glucose-sparing regimen (P-E-N) improved glycemic control as measured by serum fructosamine. Further studies are needed to establish fructosamine targets that will reduce the morbidity risk related to hyperglycemia in PD patients.
Keyword Fructosamine
Glycemic control
Peritoneal dialysis
HbA1c
Chronic kidney disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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