Diabetes Clinical Trial
The aims of this study are to assess the potential efficacy and safety of insulin pump to improve glycemic control in conjunction with continuous glucose monitoring (CGMS) for diabetic continuous ambulatory peritoneal dialysis (CAPD) patients.
Diabetic nephropathy now accounts for 20% to 40% of all patients entering end-stage renal
failure (ESRF) programs. The quality of glycemic control is known to be an important
determinant of the rate of progression of patients with diabetic continuous ambulatory
peritoneal dialysis (CAPD) patients. Diabetic CAPD patients are usually treated with
dialysis fluids utilizing glucose as the osmotic agent to provide ultrafiltration. Most of
diabetic CAPD patients had HbA1c readings above 7% despite the recommendation to keep the
reading below 7%.
The continuous blood glucose monitor (CGMS) has recently offered an opportunity to monitor
blood glucose at 5-minute intervals for 72 continuous hours in diabetic patients. The CGMS
patterns reveal blood glucose tracings well above the recommended standards of control in
most of the diabetic CAPD patients.
Good glycemic control is often difficult to maintain in diabetic patients treated with CAPD
because they are continuously exposed to high concentrations of glucose in peritoneal
dialysate. However, recent studies have suggested that diabetic patients who use insulin
pump has been shown to reduce glycated hemoglobin levels without an increased risk of
hypoglycemia, as compared with a regimen of multiple daily insulin injections, but results
in diabetic CAPD patients have not been reported.
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Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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