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

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 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.