Table 1.

Long-term glycemic monitoring and management in advanced chronic kidney disease

Population	HbA1c	Frequency	Glycemic indexing by CGMI	Insulin requirements
CKD stages 1 to 5 including kidney transplant	Yes	Twice per year Up to 4 times per year if not achieving target or change in therapy	Correlate interstitial glucose with HbA1c for individual patients	Lower 25% to 30% basal insulin dose for patients with T1D and CKD 3 (129)
CKD stage 5 on dialysis	No	Not applicable	Consider	Lower 50% TDD for patients with type 2 with CKD-V (36) Lower total daily insulin dose by 35% to 40% for patients with T1D and CKD V (36) Lower (25%) basal insulin dose for pre-HD days (37)

CKD stages are based on estimated glomerular filtration ratios as follows: stage I: less than 90, stage II: 60 to 89, stage III: less than 60, stage IV: less than 30, stage V: less than 15 mL/min/1.73 m²).

Abbreviations: HbA_1c, hemoglobin A_1c; CKD, chronic kidney disease; CGMI, CGM Glucose Management Indicator; TDD, total daily insulin dose; HD, hemodialysis; T1D, type 1 diabetes; T2D, type 2 diabetes.