1346-P: Hypoglycemia Fear in Dialysis Patients with Diabetes: An Analysis of the NIH CONDOR Trial

Introduction and Objective: ESKD patients with diabetes mellitus (DM) are susceptible to hypoglycemia via multiple pathways, including decreased kidney gluconeogenesis, impaired metabolism/clearance of DM medications, co-existing comorbidities (gastroparesis, protein-energy wasting), limited in-center hemodialysis (HD) food access, and intradialytic glucose shifts. While hypoglycemia has been associated with higher mortality risk in ESKD, little is known about the burden of hypoglycemia fear in this population. Methods: We sought to evaluate the burden of hypoglycemia fear in a substudy of the NIH “Continuous Glucose Monitoring in Dialysis Patients to Overcome Dysglycemia (CONDOR)” Trial. In a subcohort of 32 hemodialysis patients with DM, we administered the Hypoglycemia Fear Survey II (HFS-II), a validated 33-item questionnaire evaluating fear of hypoglycemia across worry (score range 0-72) and behavior domains (score range 0-60) (higher scores indicate greater hypoglycemia-related fear) at study entry. Results: Among 32 hemodialysis patients with DM, the baseline HFS-II Worry subscale min-max values and mean±SD values were 0-44 and 10.3±10.9 respectively. The baseline HFS-II Behavior subscale min-max values and mean±SD values were 0-44 and and 5.9±11.4, respectively. Conclusion: These findings suggest wide variation and substantial burden of hypoglycemia-related fear in dialysis patients with DM. Further research is needed to determine if hypoglycemia fear influences DM self-management and whether targeted interventions mitigate its impact on clinical outcomes. Disclosure C. Rhee: None. A. Daza: None. Y. Narasaki: None. D. Nguyen: None. K. Kalantar-Zadeh: Consultant; Current; Fresenius Medical Care. Funding NIH (DK1248390)