DeepaH Usulumarty’s scientific contributions

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Publications (2)


Figure 3: (a) The12 hour glucose pattern (4 hours pre, 4 hours post and during HD) in ESDN and ESRD group. (b) Comparison of Glycemic Pattern on HD between Group A and Group B b
Figure 4: Duration (width) and severity (height) of hypoglycemia episodes of 10 patients
Duration and severity of no. of episodes hypoglycemia of 10 patients Patient no No. of episodes Time duration (mins) Lowest glucose value ≤70 mg/dl (43%) ≤54 mg/dl (9%) ≤40 mg/dl (3%)
Targeting Predialysis Glucose up to 180 mg/dl Reduces Glycemic Variability in End Stage Diabetic Nephropathy
  • Article
  • Full-text available

November 2022

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21 Reads

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2 Citations

Indian Journal of Endocrinology and Metabolism

Nikita Shah

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JugalV Gada

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VishwanathS Billa

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[...]

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NikhilM Bhagwat

Context: Glycemic variability plays a major role in the development as well as the progression of cardiovascular disease in diabetes. Aims: We compared the mean plasma glucose and glycemic variability (GV) parameters on and off hemodialysis (HD) in patients with End-Stage Diabetic Nephropathy (ESDN) and End-Stage Renal Disease (ESRD). Settings and design: Cross-sectional study. Methods and material: We included 23 ESDN and 6 ESRD patients who underwent continuous glucose monitoring (CGM) (iPro2) for 6 days and a glucose-free dialysate for 4 hours thrice weekly. EasyGV software was used to calculate the variability parameters {mean glucose, Time in range (TIR), Time above and below range (TAR/TBR), CV (Coefficient of Variation) and MAGE}. Statistical analysis used: The quantitative data variables were expressed by using mean and SD. Unpaired t-test was used to compare the two groups. P value <0.05 was considered significant. Results: In the ESDN group, TIR was significantly lower whereas TAR and TBR were significantly higher on HD day. MAGE (101.88 ± 40.5 v/s 89.46 ± 30.0, P < 0.007) and CV (29.41% v/s 21.67%) were higher on HD day. Subjects with pre-HD glucose values ≥180 mg/dl (Group B, n = 24) had a rapid drop with a delayed higher rise in glucose values than those with pre-HD glucose values <180 mg/dl (Group A, n = 27). Ten patients had 13 episodes of hypoglycemia. The CGM parameters were not different in the ESRD group. Conclusions: Targeting a pre- HD glucose value <180 mg/dl could be a good strategy to prevent larger fluctuation during and post HD.

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Citations (1)


... Hypoglycemia raises the risk of cognitive dysfunction and can cause fatal arrhythmia. Severe hypoglycemia may lead to coma or death, and the risk of hypoglycemia events grows with intensive blood glucose treatment [11][12][13]. Post-HD hyperglycemia causes oxidative stress, inflammation, cell death, and increased glucose toxicity, leading to clinical symptoms and potentially being life-threatening [7]. Excessive glucose fluctuation may be more dangerous than persistent abnormal blood glucose. ...

Reference:

Research Progress on the Application of CGM in Patients with Diabetes and Hemodialysis
Targeting Predialysis Glucose up to 180 mg/dl Reduces Glycemic Variability in End Stage Diabetic Nephropathy

Indian Journal of Endocrinology and Metabolism