Table 1. Tests to diagnose and monitor diabetes.

HD: hemodialysis; 1,5-AG: 1,5-anhydroglucitol; CGM: continuous glucose monitoring; OGTT: oral glucose tolerance test.

Test	Description	Advantages	Disadvantages
HbA1c	The most common test reflects average blood sugar control over 2–3 months. It predicts mortality in those with HD [12].	Easy to perform and standardized.	Accuracy declines with advanced CKD (G4-G5), particularly HD patients [13], and varies with drugs like protease inhibitors, [9] NRTIs, aspirin, vitamin C and E [14]. Falsely high A1c in metabolic acidosis false low A1c: high RBC turnover like Anemia, transfusion, Hemodialysis blood loss, ESA, and iron supplements [15,16]
Fructosamine	Less affected by factors that decrease HbA1c	It may be helpful in cases where HbA1c decreases.	Reliability decreases with advanced CKD. It may not add to the existing value provided by the HbA1C.
Glycated albumin	Measures sugar attached to albumin protein	May be useful in some CKD cases.	Unpredictable with inflammation, low albumin, and peritoneal dialysis. Frequent testing (every 2-4 weeks).
1,5-AG	Rapid glycemic changes and postprandial glucose were more accurate than HbA1c or fructosamine.	Not affected by red blood cell or protein turnover, unlike other markers [17-19].	Low levels seen in CKD can be misleading.
CGM	Measures interstitial fluid glucose levels, providing real-time data	May be useful for CKD patients at risk for hypoglycemia, offers personalized data and tailored plans [13].	Not yet approved for dialysis patients, costlier.
OGTT	Gold standard for diagnosing post-transplant diabetes [20]	Not recommended for routine monitoring.	Time-consuming test.