{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:23:56Z","timestamp":1784287436059,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"5-6","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies suggested adjusting insulin doses during hemodialysis to reduce intra\u2010 and post\u2010hemodialysis hypoglycemia. However, the impact of insulin adjustment on cardiovascular morbidity and mortality in diabetic patients with end\u2010stage renal disease (ESRD) remains unclear. Although reducing hypoglycemia is a well\u2010documented benefit of insulin dose modification in this population, the broader metabolic and inflammatory consequences\u2014particularly those related to cardiovascular risk\u2014are not well understood. This study aimed to investigate the effects of a 25% reduction in total daily insulin dose on hemodialysis days in T2DM patients with ESRD, focusing on daily blood glucose profiles, glycated albumin, IL\u20106, and TNF\u2010\u03b1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter study with clinical trials was designed in five hemodialysis centers. It was a 4\u2010week clinical trial involving 17 eligible type 2 diabetic patients with ESRD on insulin therapy and regular hemodialysis. Self\u2010monitoring blood glucose was performed seven times a day before, during, and 1\u2009month after the intervention. Blood samples were collected before and after the intervention. The Wilcoxon test was used to assess differences in daily glucose profiles, glycated albumin, IL\u20106, and TNF\u2010\u03b1 before and after insulin dose adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After 1\u2009month of adjusting total daily insulin dose during hemodialysis, no statistically significant difference was observed in daily blood glucose, IL\u20106, and TNF\u2010\u03b1 levels. However, glycated albumin levels increased both before and after the insulin dosage modification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reducing the total daily insulin dose by 25% during hemodialysis day effectively reduces hypoglycemia incidence intra\u2010 and post\u2010hemodialysis in T2DM patients with ESRD without impacting pro\u2010inflammatory factors IL\u20106 and TNF\u2010\u03b1, which are associated with increased cardiovascular morbidity and mortality risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sdi.70007","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:21:57Z","timestamp":1756275717000},"page":"316-325","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Insulin Dosage Adjustment on Hemodialysis Day for Blood Glucose Levels, Glycated Albumin, Interleukin\u20106, and TNF\u2010\u03b1 in Patients With Type 2 Diabetes Mellitus and End\u2010Stage Renal Disease"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0569-4617","authenticated-orcid":false,"given":"Hendra","family":"Zufry","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Metabolism, and Diabetes \u2013 Thyroid Center, Department of Internal Medicine, School of Medicine Universitas Syiah Kuala  Banda Aceh Indonesia"},{"name":"Division of Endocrinology, Metabolism, and Diabetes \u2013 Thyroid Center, Department of Internal Medicine Dr. Zainoel Abidin Hospital  Banda Aceh Indonesia"},{"name":"Innovation and Research Center of Endocrinology, School of Medicine Universitas Syiah Kuala  Banda Aceh Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna\u00a0Wardhana","family":"Sucipto","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism, and Diabetes \u2013 Thyroid Center, Department of Internal Medicine, School of Medicine Universitas Syiah Kuala  Banda Aceh Indonesia"},{"name":"Division of Endocrinology, Metabolism, and Diabetes \u2013 Thyroid Center, Department of Internal Medicine Dr. Zainoel Abidin Hospital  Banda Aceh Indonesia"},{"name":"Innovation and Research Center of Endocrinology, School of Medicine Universitas Syiah Kuala  Banda Aceh Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agustia\u00a0Sukri","family":"Ekadamayanti","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism, and Diabetes \u2013 Thyroid Center, Department of Internal Medicine, School of Medicine Universitas Syiah Kuala  Banda Aceh Indonesia"},{"name":"Division of Endocrinology, Metabolism, and Diabetes \u2013 Thyroid Center, Department of Internal Medicine Dr. Zainoel Abidin Hospital  Banda Aceh Indonesia"},{"name":"Innovation and Research Center of Endocrinology, 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