PP135 - MUSCLE STRENGTH AND PHYSICAL ACTIVITY AS KEY MODIFIERS OF GLYCAEMIC VARIABILITY IN PERITONEAL DIALYSIS

PP135

MUSCLE STRENGTH AND PHYSICAL ACTIVITY AS KEY MODIFIERS OF GLYCAEMIC VARIABILITY IN PERITONEAL DIALYSIS

T. Simčič¹, A. Poročnik², J. Pajek^1,3, B. Knap^1,3,*

¹University Medical Centre, Ljubljana, ²Health centre Radlje ob Dravi, Radlje ob Dravi, ³Faculty of Medicine, Universtity of Ljubljana, Ljubljana, Slovenia

Rationale: Peritoneal dialysis (PD) patients are subject to continuous glucose absorption from dialysate, contributing to metabolic disturbances and protein-energy wasting. This study aimed to quantify the glucose burden from dialysate and determine how muscle strength and physical activity correlate with glycaemic stability using continuous glucose monitoring (CGM).

Methods: We conducted a clinical cohort study of 20 PD patients. Assessments included 10-day CGM, physical activity tracking (steps per day), handgrip strength (HGS), 5-repetition sit-to-stand (STS) test and 24-hour recall. 

Results: Dialysate glucose absorption averaged 55,9 ± 30,5 g/day, accounting for 13,7 ± 7,7 % of total daily energy intake. 85 % of patients failed to meet ESPEN protein targets for PD patients (mean intake = 0,7 g/kg BW), and 80 % had insufficient oral energy intake (mean intake = 20,7 kcal/kg BW). While HbA1c levels were normal (mean = 5,14 %), CGM revealed a mean interstitial glucose of 6,66 mmol/L, coefficient of variation (CV) of 19,85 %, time in range (TIR) of 94,58 % and a glycaemic management indicator (GMI) of 6,22 % . Functional capacity was the strongest predictor of glycaemic control. The STS test showed a strong negative correlation with CV (ρ = -0,756, p < 0,001). Daily step count and HGS were also significantly correlated with reduced glycaemic variability (p < 0,05), whereas oral dietary intake showed no significant association with glycaemic variability.

Conclusion: The continuous glucose load from dialysate in PD patients significantly contributes to total energy intake but also masks underlying hyperglycaemia. Functional muscle capacity and physical activity are the primary modifiable factors in glycaemic control for this population. Clinical management should prioritise structured exercise and optimisation of protein intake to lower the metabolic risks associated with PD.

Disclosure of Interest: None declared