1013-P: Evaluation of a Continuous Glucose Monitor in Patients with Diabetes on Hemodialysis
Bibliographic record
Abstract
Diabetes management is critical for patients with end-stage renal disease (ESRD). Patients with ESRD experience impaired glucose metabolism, necessitating continuous monitoring. Continuous Glucose Monitors (CGMs) are an effective instrument to monitor glucose levels. The Flash Glucose Monitor (FGM), a CGM variation, displays live, on-demand glucose data; however, the accuracy of FGMs on patients with diabetes on hemodialysis in Canada is not well supported. This study investigates the accuracy of the Freestyle Libre 2, an FGM, in patients with diabetes on hemodialysis at the Windsor Regional Hospital in Windsor, Ontario. A prospective cohort study was performed. Participants ≥ 18 years of age with type 1 or 2 diabetes undergoing hemodialysis were invited to participate. Over 14 days, blood glucose was collected using a capillary blood glucose monitor (CBGM) and FGM four times daily. Accuracy of FGM was assessed via Mean Absolute Relative Difference (MARD), while a Clarke Error Grid correlated paired results between FGM and CBGM. Among 398 paired readings from 8 participants, mean age was 56.8 +/- 4.9 years, 62.5% were male, mean A1C was 7.7 +/- 2.2%, and 25% and 75% had type 1 and type 2 diabetes, respectively. The MARD between the FGM and CBGM was 10.5 ± 8.9%, with 83% of FGM values within ± 1.5 mmol/L of CBGM values. Clarke Error Grid analysis showed 94.5%, 5.5%, 0%, and 0% of correlated pairs in zone A, zone B, zone C, zone D, and zone E respectively, indicating 100% of values within the clinically safe range. Results support the clinical use of Freestyle Libre 2 in patients with diabetes on hemodialysis. With accurate monitoring using FGMs, physicians can better manage hypoglycemia and hyperglycemia associated with hemodialysis, thereby improving patient outcomes. Future work should aim to increase sample size, compare sensor accuracy in patients with diabetes without hemodialysis, and those on peritoneal dialysis. Disclosure M. Modi: None. M. Bagga: None. Funding WE-Spark Igniting Discovery Grants Program (Tayfour-Emara Research & Education Fund); Schulich-UWindsor Opportunities for Research Excellence Program (SWORP); No reference number indicated.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".