Diabete mellitus (DM) is a major health issue affecting 422 million people worldwide. Among them, 20–40 % will develop a chronic renal disease (CKD) which can lead to end-stage renal disease require replacement therapy [1].

In hemodialysis, DM has a major impact on prognosis and on survival. In France, the 10- year survival in dialysis patient with DM is 19 % compared to 40 % without [[2], [3], [4]].

Glycated hemoglobin (HbA1c) is the reference parameter for DM monitoring [3]. In patients with diabetes on hemodialysis, a glycated hemoglobin < 7 % is associated with an higher mortality risk [4,5]. However, several factors influence its values: the reduction in the lifespan of red blood cells [6], anemia and correction of this anemia by treatment with iron, erytropoeitin (EPO), transfusion [[7], [8], [9]], glycation abnormality, assay interference [10] or chronic inflammation [11,12). All of this factor lead to an underestimation of HbA1c [[13], [14], [15]]. Futhermore, DM and HD population are at a greater risk of hypoglycemia and has been associated with high risk of mortality [4,15,16]. Mechanism of hypoglycemia in HD are: decrease in renal gluconeogenesis, decrease in insuline clearance, glucose lose into the dialysate, loss of dietary intake leading to a phenomemenon of « burn out diabetes » in dialysis [14] as well as the effects of antidiabetic treatment such as insulin and repaglinide [1].

The use of continuous glucose monitoring (CGM) could be an interesting tool to assess glycemic control in HD population, already demonstrated in diabetes 1 and diabetes 2 leading to a better glucose control, less hypoglycemia and less ketoacidosis [[17], [18], [19]]. The accuracy of CGM in the hemodialysis population has been established [[20], [21], [22]]. CGM highlith non-symptomatic hypoglycemia, difference beetween glucose profil dialysis days and non-dialysis days, glycemic variability beyond the dialysis day cycle [23]. It reveals glycemic variability, a parameter that has furthermore been associated with excess mortality [24]. However, no study compare the usefulness of 14 days CGM compare to HbA1c alone in assesing glycemic control and only one performed CGM with Freestyle libre pro (FSL-pro) [25].

We propose a study to evaluate glucose control in DM and HD population with the data provide with 14 days CGM (TIR, TBR) compared to HbA1c alone, according to international recommendation [1,26,27].