Prevalence of impaired fasting glycemia, impaired glucose tolerance, and type 2 diabetes in hemodialyzed patients when applying new diagnostic criteria.

摘要

OBJECTIVE: Recently, the American Diabetes Association (ADA) proposed a new diagnostic entity for diabetes mellitus that has not been applied in renal failure patients so far. Our goal was to apply the new impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) criteria in a group of hemodialyzed patients to provide data on glucose alterations in chronic renal failure. DESIGN AND PATIENTS: We evaluated 74 hemodialyzed patients, (38 women, 36 men) without diagnosed diabetes. Blood was collected at fasting and at 120 minutes after a 75-g glucose intake, and insulin levels were determined. The weight, height, waist circumference, and hip circumference of each patient were measured, and the body mass index (BMI) and waist-hip ratio were calculated. RESULTS AND CONCLUSION: Values of fasting plasma glycemia and 120-minute oral glucose tolerance test were (mean +/- SD) 78 +/- 9.4 mg/dL and 121 +/- 39 mg/dL, respectively. Among the 74 subjects studied, 5 patients had IFG, none of them showing a glucose level above 110 mg/dL. If the ADA 1997 criteria were applied, these patients would be classified as normal. On the other hand, 15 of the 74 patients showed IGT, this prevalence being higher compared with that of the general population. Finally, in 5 of the 74 patients the presence of type 2 diabetes was shown by the second test. According to sex, no differences were observed in the prevalence of IFG, IGT, or diabetes. Glucose alterations are characteristics that need to be identified in chronic renal failure patients. Our results suggests that the glucose tolerance test might be evaluated during hemodialysis treatment to define its prevalence.