Poster 17: Burden of hypoglycaemia in people with diabetes on peritoneal dialysis

The management of glycaemic control in people with diabetes on peritoneal dialysis (PD) can be challenging. The aim of this study was to report the prevalence and impaired awareness of hypoglycaemia in people with diabetes on PD.

Methods: Across 3 large hospitals, we examined the individual case-notes of patients with diabetes receiving peritoneal dialysis between December 2021 and January 2022.

Results: In total 64 people with diabetes [22% with Type 1 Diabetes] on PD (median age 63) were evaluated. The median duration of diabetes was 20 years. Similarly, median duration of peritoneal dialysis was 22 months. All participants except one were on glucose-containing dialysis regimes. Forty four people (70%) were on insulin. In total, 58% had an HbA1c <58mmol/mol, of whom 66% were on medication that could be associated with hypoglycaemia.

Using Clark Score criteria, 13% of our cohort (including 4 people with type 1 diabetes) had hypoglycaemia-unawareness. Similarly, 15% had Gold score of 4 or greater indicative of impaired awareness of hypoglycaemia. Self-reported hypoglycaemic events (at least 1 event per month) were reported by 21% of individuals. Seven of 44 people on insulin utilised intermittent glucose monitoring systems.

Conclusion: We observed that ~15% of people with diabetes on PD had impaired awareness of hypoglycaemia. 58% had an HbA1c <58mmol/mol of whom two thirds were on treatments that could cause hypoglycaemia. The use of technology to aid diabetes care was low. Our results highlights the need for greater interdisciplinary working to help improve diabetes care in this high risk group.