# Hypoglycemia and glycemic control in patients treated with dialysis

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $636,109

## Abstract

PROJECT SUMMARY/ABSTRACT
Hypoglycemia and hyperglycemia are common and morbid problems for end stage kidney disease patients
treated with dialysis. Severe hypoglycemia occurs frequently among dialysis patients with and without diabetes
due to reduced kidney gluconeogenesis, protein-energy wasting, a blunted counter-regulatory response, and
reduced medication clearance and may cause substantial morbidity due to accidents, arrhythmias, and
cardiovascular events. However, accurate rates of hypoglycemia (including subclinical episodes),
hypoglycemia risk factors, and associations of hypoglycemia with clinical outcomes are not known in the
dialysis population. Conversely, hyperglycemia due to inadequately treated diabetes may promote painful
peripheral neuropathy, vision-threatening retinopathy, and infections, but standard measures of glycemia such
as hemoglobin A1c are known to be unreliable among dialysis patients, leading to diagnostic and therapeutic
nihilism. The goal of this research project is to comprehensively define glycemia in dialysis patients using
modern continuous glucose monitoring (CGM) technology, informing needs for clinical care and building a
foundation for intervention studies. CGM offers a new paradigm for glycemia assessment and management
that can provide new scientific insights and potentially change the clinical approach to glycemic management.
However, there has been no large, externally valid study to understand the incidence or severity of
abnormalities detectable by CGM, identify which patients may benefit most from use of CGM, or examine
whether CGM metrics are related to clinically relevant outcomes in this population. We propose a prospective
community-based cohort study of 800 patients treated with dialysis at Northwest Kidney Centers, a not-for-
profit organization that provides the majority of dialysis care in the greater Seattle metropolitan area. The
foundation of the cohort study will be a 10-day period of CGM, performed at baseline using cutting-edge
technology. A participatory approach to research will enhance enrollment, external validity, and clinical
relevance. With this cohort, we aim to (1) determine the incidence and severity of hypoglycemia and its clinical
risk factors among dialysis patients with and without diabetes; (2) define the distribution and clinical correlates
of glucose time in range and related CGM metrics among dialysis patients with diabetes; and (3) test
associations of hypoglycemia and time in range with clinical outcomes relevant to dialysis patients. Results
may suggest opportunities for CGM implementation to improve clinical care and will define appropriate
populations, interventions, outcomes, and power assumptions for clinical trials.

## Key facts

- **NIH application ID:** 10071048
- **Project number:** 1R01DK126373-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Ian H de Boer
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $636,109
- **Award type:** 1
- **Project period:** 2020-08-21 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10071048

## Citation

> US National Institutes of Health, RePORTER application 10071048, Hypoglycemia and glycemic control in patients treated with dialysis (1R01DK126373-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10071048. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*