Assessment of glycemic control in dialysis patients with diabetes: Glycosylated hemoglobin or glycated albumin?

摘要

The natural history of diabetes is characterized by thevariable occurrence and severity of microvascular(nephropathy, retinopathy, neuropathy) and macrovascular(atherosclerotic cardiovascular) complications.A large body of laboratory data lends credenceto the argument that hyperglycemia is central to thegenesis and progression of both micro- and macrovascularcomplications of diabetes. This notion, however,has been only partially validated. Several largerandomized, controlled trials have consistently demonstratedthat aggressive glycemic control slows theappearance and/or progression of microvascularcomplications (1–3). However, the evidence that aggressiveglycemic control ameliorates the macrovascularcomplications in individuals with diabetes isless robust (2– 4).