Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control

Betônico, Carolina C. R.; Titan, Sílvia M. O.; Côrrea-Giannella, Maria Lúcia; Nery, Márcia; Queiroz, Márcia Silva

doi:10.6061/clinics/2016(01)08

Cited by 53 publications

(49 citation statements)

References 69 publications

(81 reference statements)

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“…The main incretins in humans are GLP‐1 and glucose‐dependent insulinotropic polypeptide (GIP), which are secreted by the intestines after every meal. GLP‐1 receptor agonists then, work by the stimulation of GLP‐1 receptors, enhancing insulin secretion, appetite suppression, delaying gastric emptying, and inhibiting glucagon release from the pancreas . Current clinically used GLP‐1 RAs are resistant to Dipeptidyl Peptidase 4 (DPP4) cleavage and are generally long‐acting drugs, reducing HbA1C with a variability between 1.3% and 1.9% .…”

Section: Insulin Secretagoguesmentioning

confidence: 99%

“…In fact, insulin clearance is highly dependent on GFR, and dose adjustment is necessary. Up to 50% reduction of total daily dose is recommended when eGFR falls between 10 and 50 mL/min/1.73 m 2 , and 75% reduction is indicated for eGFR below 15 mL/min/1.73 m 2 …”

Section: Insulinmentioning

confidence: 99%

“…Up to 50% reduction of total daily dose is recommended when eGFR falls between 10 and 50 mL/ min/1.73 m 2 , and 75% reduction is indicated for eGFR below 15 mL/ min/1.73 m 2 . 55 New routes of administrations such as inhaled insulin have shown to be effective in achieving glycaemic control as well. Although it is a viable alternative in DKD patients,, drug absorption is significantly variable and this route of administration may cause small pulmonary function changes, making it contraindicated in patients with COPD and asthma.…”

Section: Insulinmentioning

confidence: 99%

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Safety and efficacy of antihyperglycaemic agents in diabetic kidney disease

Niezen

Castillo

Castaner

et al. 2019

Endocrino Diabet & Metabol

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Diabetic kidney disease (DKD) is the major contributor to the mortality and the financial burden of diabetes, accounting for approximately 50% of the cases of end‐stage renal disease (ESRD) in the developed world. Several studies have already demonstrated that achieving blood pressure targets in DKD with agents blocking the renin‐angiotensin system confer superior renoprotection when compared to other agents. However, the effects on renal outcomes of antihyperglycaemic agents in these patients have not been reported or studied broadly until recent years. The intent of this article is to review the available data on safety, efficacy, impact on renal outcomes and pathophysiology implications of the most utilized antihyperglycaemic agents in DKD/ESRD.

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Section: Insulin Secretagoguesmentioning

confidence: 99%

Section: Insulinmentioning

confidence: 99%

Section: Insulinmentioning

confidence: 99%

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Safety and efficacy of antihyperglycaemic agents in diabetic kidney disease

Niezen

Castillo

Castaner

et al. 2019

Endocrino Diabet & Metabol

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“…Diabetes mellitus is an underlying cause of chronic kidney disease [48] . It develops certain degree of damage and lead to abnormal kidney function.…”

Section: ++mentioning

confidence: 99%

Hypoglycaemic Effect of Glibenclamide: A Critical Study on the Basis of Creatinine and Lipid Peroxidation Status of Streptozotocin-induced Diabetic Rat

Pandarekandy¹,

Sreejesh²,

Thampi³

et al. 2017

pharmaceutical-sciences

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Seena, et al.: A Critical Study on Hypoglycaemic Effect of GlibenclamideThe present study is aimed to evaluate the hypoglycaemic effect of glibenclamide monotherapy on streptozotocin-induced diabetic rats and therapeutic impact of this agent on various organs by measuring the oxidative stress biomarker, lipid peroxidation and creatinine after a specific period of oral treatment. Eighteen male Wistar rats were taken of which twelve were randomly selected and diabetes was induced using streptozotocin (40 mg/kg) intraperitoneally, while 6 rats were vehicle injected. After inducing diabetes, the animals were grouped into healthy normal, diabetic control and diabetic test groups. The diabetic test rats were treated with glibenclamide (10 mg/kg) orally for 10 days continuously. On the 30th day of the experiment, all the animals were sacrificed and their blood and a portion of both the liver and pancreas were taken for biochemical analysis. The experimental parameters such as body weight, fasting blood glucose level, serum creatinine level and tissue lipid peroxidation status using malondialdehyde assay were investigated. All the results of the experimental data were analysed statistically using one-way analysis of variance using the SPSS 16. The current study reveals that glibenclamide treatment has a significant role in lowering the blood glucose but at the same time it increased the oxidative stress, which was reflected in the elevated malondialdehyde activity of both the hepatic and pancreatic tissues.

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“…Glycemic control in patients with chronic kidney disease (CKD) adds another layer of complexity. Diabetes is the leading cause of CKD and a major public health issue worldwide. Approximately 25% of type 2 diabetes mellitus patients in Japan have renal impairment (RI) classified as moderate‐to‐severe CKD (glomerular filtration rate <60 mL/min/1.73 m 2 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of trelagliptin in Japanese patients with type 2 diabetes with severe renal impairment or end‐stage renal disease: Results from a randomized, phase 3 study

Kaku

Ishida

Shimizu

et al. 2019

J of Diabetes Invest

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Introduction To investigate the efficacy and safety of trelagliptin 25 mg in patients with type 2 diabetes mellitus with severe renal impairment or end‐stage renal disease. Materials and Methods This multicenter, randomized, phase 3 study comprised a 12‐week double‐blind phase followed by a 40‐week open‐label phase. Patients had type 2 diabetes mellitus with severe renal impairment (creatinine clearance <30 mL/min) or end‐stage renal disease (undergoing hemodialysis), and were receiving diet and/or exercise therapy with/without one antidiabetic drug. Results Patients were randomized to trelagliptin (A/A, n = 55) or placebo (P/A, n = 52; double‐blind phase). Both groups received trelagliptin in the open‐label phase. The least square mean change (95% confidence interval [CI]) from baseline in hemoglobin A1c at the end of the double‐blind phase was −0.71% (95% CI −0.885, −0.542) and 0.01% (95% CI −0.170, 0.183) in the A/A and P/A groups, respectively (intergroup least square means difference −0.72%, 95% CI −0.966, −0.473; P < 0.0001). Mean hemoglobin A1c decreased after trelagliptin treatment in the P/A group to similar levels observed in the A/A group and remained comparable in both groups versus baseline up to week 52. In the double‐blind phase, the incidence of treatment‐emergent adverse events (TEAEs) was 72.7% and 61.5% in the A/A and P/A group, respectively; most TEAEs were mild‐to‐moderate, except in one patient (P/A group), who experienced two severe TEAEs. The incidence of serious TEAEs was 7.3% and 3.8% in the A/A and P/A group, respectively. Conclusions Once‐weekly trelagliptin 25 mg was efficacious, with no major safety concerns, and represents a meaningful treatment option in this patient population.

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Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control

Cited by 53 publications

References 69 publications

Safety and efficacy of antihyperglycaemic agents in diabetic kidney disease

Safety and efficacy of antihyperglycaemic agents in diabetic kidney disease

Hypoglycaemic Effect of Glibenclamide: A Critical Study on the Basis of Creatinine and Lipid Peroxidation Status of Streptozotocin-induced Diabetic Rat

Efficacy and safety of trelagliptin in Japanese patients with type 2 diabetes with severe renal impairment or end‐stage renal disease: Results from a randomized, phase 3 study

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