الفهرس 
• Diabetes mellitus in ESRDOnly 14 pages are availabe for public view
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Abstract
Background: Diabetes is a potent cardiovascular risk factor in people with end-stage renal disease. In those patients the role of tight glycemic control is questioned.
Aim of Work: The present study aimed to evaluate the status of glycemic control in diabetic patients undergoing hemodialysis. In addition, we prospected to identify the risk factors associated with poor glycemic control and the subsequent morbidities with particular emphasis on cardiovascular complications.
Patients and Methods: We recruited 400 diabetic patients on maintenance HD. They were subjected to careful history taking, thorough clinical examination, routine laboratory investigations and glycemic control assessment using HbA1C. In addition they were followed up for 1 year to record the major outcome endpoints including mortality, cardiac and cerebrovascular events and hospitalizations for relevant morbidities.
Results: Good glycemic control was achieved only in 183 patients (45.8 %). Comparison between patients with good and poor glycemic control regarding the serum lipids had shown statistically significant higher serum cholesterol, triglycerides and LDL and lower HDL in patients with poor glycemic control. Also, patients with poor glycemic control had significantly lower PTH levels. Poor glycemic control was a significant predictor of CV events in the studied patients. In relation to the mortality rate, the present study reported that 28 patients (7.0 %) died during the 1 years study period. In respect to the relation between glycemic control and mortality, the present study found a statistically significant higher frequency of mortality in patients with poor glycemic control. In the present study, it was shown that 296 (74.0 %) of the studied patients had atherosclerotic changes. Also, the present study found a statistically significant higher frequency of athersclerosis in patients with poor glycemic control when compared with patients with good control.
Conclusions: Good glycemic control was achieved only in 183 patients (45.8 %). Patients with good control had lower mortality, lower CV events and lower atherosclerotic changes