Study to Determine the Efficacy of Real-time CGM in Preventing Hypoglycemia Among Insulin-treated Patients With DM2 on Hemodialysis, Compared to Standard of Care (POC BG)

Inclusion Criteria:

• adult subjects with type 2 diabetes

• receiving hemodialysis (for at least 90 days)

• treated with insulin therapy [basal insulin alone (glargine U100, glargine U300,detemir, degludec, NPH)], or in combination with bolus insulin (at least one or moreinjections of aspart, lispro, glulisine, regular insulin) or in combination withincretin therapy (DPPIV or GLP1)

• willingness to wear the CGM

• currently performing self-monitored blood glucose (at least 2 times daily).

Exclusion Criteria:

• use of sulfonylureas or thiazolidinediones alone or in combination with insulin

• use of personal/real-time CGM 3 months prior to study entry (blinded CGM is allowed)

• prior use of insulin pumps or hybrid close loop systems (for at least the prior 28days)

• current or anticipated use of stress steroids doses (prednisone ≤5mg or itsequivalent is allowed)

• subjects who are sensitive or allergic to adhesive

• extensive skin changes/diseases that preclude wearing the required number of deviceson normal skin (e.g., extensive psoriasis, recent burns or severe sunburn, extensiveeczema, extensive scarring, extensive tattoos, dermatitis herpetiformis) at theproposed wear sites

• any condition that, in the opinion of the Investigator, would interfere with theirparticipation in the trial (e.g., marked visual or hearing impairment, activealcohol or drug abuse, mental illness) or pose excessive risk to study staffhandling venous blood samples

• situations that will limit the subject's ability to comply with the protocol (perinvestigator discretion)

• active malignancy

• unable to give informed consent

• at least 10% of time spent in clinical relevant hypoglycemia (<54 mg/dl) duringblinded CGM period

• significant hypoglycemia (< 40 mg/dL)

• severe hyperglycemia (BG> 400 mg/dL)

• extensive skin abnormalities at insertion sites

• pregnancy or breastfeeding

• severe anemia (Hemoglobin < 5 mg/dl)

• polycythemia (Hemoglobin >17 mg/dl)

• subjects taking acetaminophen (more than 1 gr every six hours)

• hydroxyurea (may cause interference with the sensor membrane).