Blood sugar control important in diabetics on dialysis

NEW YORK (Reuters Health) - Good control of blood sugar in diabetic patients with chronic kidney disease who undergo regular hemodialysis is an independent predictor of a better prognosis, a team of Japanese researchers report.

Strict control of blood sugar in diabetic patients "decreases diabetes complications, which determine the quality of life and prognosis of such patients," report Dr. Masanori Emoto, of Osaka City University Graduate Medical School and colleagues in the journal Diabetes Care.

In a long-term observational study, the researchers looked at the impact of glycemic control on survival during regular hemodialysis in 114 diabetic patients over an average of about 45 months.

They found that patients with elevated hemoglobin A1C levels -- an indicator of poor blood sugar control -- had a significantly lower survival rate than those with lower A1C levels, an indicator of better blood sugar control.

Analyses adjusting for potentially confounding factors revealed that a poor A1C level was a significant predictor of death, and these patients were more likely to die from cardiovascular disease or infection than patients with fair or good A1C levels.

These findings, the team concludes, highlight the importance of achieving good blood sugar control for improving the outlook of diabetic patients on dialysis. "Our findings may thus be applicable to the management of diabetic patients on regular hemodialysis."

SOURCE: Diabetes Care July 2006.