425-P: Retrospective Analysis of Glycemic Profiles and Variabilities Using Continuous Glucose Monitoring in Elderly People with Type 2 Diabetes Undergoing Hemodialysis

People with type 2 diabetes undergoing hemodialysis (T2HD) exhibit distinct glycemic profiles. The details of glycemic profiles in elderly people with T2HD, however, remain unclear. Sensor glucose levels (SGLs) were analyzed using continuous glucose monitoring (CGM) in 116 subjects with T2HD, investigating differences in clinical parameters and CGM metrics between elderly group (≥ 65 years) and non-elderly group (< 65 years). For retrospective analysis, 55 in elderly group (39 males, age 72 years, HbA1c 6.3%, glycated albumin (GA) 22.5%) and 61 in non-elderly group (41 males, age 52 years, HbA1c 6.7%, GA 19.8%) were selected. Among these, 30 (54.6%) in elderly group and 48 (78.7%) in non-elderly group were on insulin therapy (p=0.0057). While no difference was observed in HbA1c between the two groups, GA was significantly higher in elderly group (p=0.0401). Mean and SD of SGL showed no difference between the two groups, but %CV was significantly higher in elderly group (30.0±7.6% vs 37.0±7.7%, p=0.0357). There was no disparity in time in range (TIR, 70-180 mg/dL), time below range (TBR, < 70 mg/dL), and time above range (TAR, > 180 mg/dL). However, TBR (< 54 mg/dL) was significantly higher in elderly group (0.63±0.19[SE]% vs 0.32±0.18[SE]%, p=0.0499). In elderly group, 30.9% experienced all-cause hypoglycemia, and 27.3% experienced hemodialysis-induced hypoglycemia, compared to 31.2% and 16.4% in non-elderly group.

In conclusion, although there was no difference in HbA1c and mean SGL between the two groups, glycemic variability and the incidence of severe hypoglycemia were significantly higher in the elderly group.