Objective: Changes in C-peptide index (CPI) before and after hemodialysis (HD) were compared to explore factors associated with insulin resistance in diabetic patients receiving HD.

Methods: Fasting blood samples were drawn from type 2 diabetic patients receiving maintenance HD but not insulin therapy at our clinic before HD on the first day of the week they went on HD (pre-HD) as well as on the next day (post-HD) and CPI was calculated.

Results: The mean post-HD CPI was significantly lower than the mean pre-HD CPI (6.7 ± 2.7 ng/mL vs. 8.1 ± 3.3 ng/mL) in the 19 type 2 diabetic patients (men/women, 12/7) included in the study. The rate of decrease in CPI was strongly positively correlated with geriatric nutritional risk index (GNRI) (R2 = 0.692) in these patients, while it was not correlated with their glycoalbumin (GA) or fasting glucose values.

Conclusions: Despite reports that HD leads to resolution of uremia and excessive fluid overload resulting in improvements in insulin resistance, to date, very few reports compared insulin resistance before and after HD. This study showed that the rate of decrease in CPI was not increased in patients with favorable glycemic control but significantly increased in those with favorable nutritional status, suggesting that the patient’s overall status may have a role to play in HD-mediated improvements in insulin resistance in the short term.
graphic
View largeDownload slide
Disclosure

S. Funakoshi: None. J. Hashiguchi: None. M. Hayashida: None. R. Etoh: None. K. Sawase: None. Y. Mori: None. K. Utsunomiya: None. T. Harada: None.

© 2018 by the American Diabetes Association.
2018
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.