Assessment of Glycemic Control in Dialysis Patients with Diabetes: Glycosylated Hemoglobin or Glycated Albumin?

摘要

The natural history of diabetes is characterized by the variable occurrence and severity of microvascular (nephropathy, retinopathy, neuropathy) and macrovascular (atherosclerotic cardiovascular) complications. A large body of laboratory data lends credence to the argument that hyperglycemia is central to the genesis and progression of both micro- and macrovascular complications of diabetes. This notion, however, has been only partially validated. Several large randomized, controlled trials have consistently demonstrated that aggressive glycemic control slows the appearance and/or progression of microvascular complications (1a€“3). However, the evidence that aggressive glycemic control ameliorates the macrovascular complications in individuals with diabetes is less robust (2a€“4).