Critical discrepancy in blood glucose control levels evaluated by glycated albumin and estimated hemoglobin A1c levels determined from a flash continuous glucose monitoring system in patients with type 2 diabetes on hemodialysis

: We aimed to investigate if estimated hemoglobin A1c (eHbA1c) levels determined using a flash continuous glucose monitoring system could be an indicator of glycemic control status in diabetic hemodialysis patients. Hemodialysis patients with type 2 diabetes were recruited. eHbA1c levels were measured using the FreeStyle Libre Flash Glucose Monitoring System®. Eighteen hemodialysis patients with diabetes were included in the study. The eHbA1cGA , calculated based on glycated albumin level and BMI and serum hemoglobin concentration were also included in the formula, was higher than the eHbA1c in most patients. Moreover, the eHbA1cGA -eHbA1c values were more than 2% in all patients with BMI <18.5 kg/m2 ; the its maximal value was 4.1%. This study shows that eHbA1c can be used as a reliable indicator for evaluating glycemic control and avoiding hypoglycemia in hemodialysis patients with diabetes, particularly those with decreased BMI.