Short-term effect of oral glucose solution in older patients with hypoglycemia undergoing hemodialysis

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Background Hypoglycemia is a common complication that is closely associated with poor prognosis in older patients with diabetes undergoing hemodialysis (HD). However, evidence regarding simple intradialytic preventive strategies remains limited. We evaluated the short-term effects of 15 g oral glucose solution on blood glucose levels and blood pressure. Methods This single-arm, self-controlled, pre-post pilot study included 12 older patients with diabetes undergoing HD between September and October 2025. Participants were selected from a previously monitored cohort according to documented hypoglycemia during HD-day continuous glucose monitoring (CGM). Patients who experienced hypoglycemia on HD received a 15 g oral glucose solution 1.5 h after starting HD. Blood glucose levels were then monitored via CGM. Paired pre-post comparisons were performed at the patient level. Blood glucose and pressure fluctuations were analyzed. Results Compared with the pre-intervention period, the incidence of hypoglycemia, time below range, and coefficient of variation were significantly lower during the entire HD day, during the HD session, and within 2 h post-HD (all P < 0.05). Mean blood glucose levels were significantly higher after the intervention ( P < 0.05). The incidence of hypotension and systolic/diastolic blood pressure did not differ significantly at any time point during HD (0–4) or before and after the intervention (all P >0.05). Conclusions Oral supplementation with 15 g of glucose solution administered 1.5 h into HD was associated with a short-term reduction in hypoglycemia in older patients with diabetes undergoing HD using glucose-free dialysate, without an observed increase in hypotension. Clinical trial registration http://www.chictr.org.cn , identifier: ChiCTR2500100945