Possibilities of Glucose-Lowering Therapy in Patients With Type 2 Diabetes Mellitus Complicated by Chronic Kidney Disease

Abstract

Abstract. Nowadays diabetes mellitus is a socially significant non-infectious disease with epidemic growth of prevalence. Over the past four years there has been a 0.17% increase in the number of patients with diabetes in Russian Federation. According to the data for 2021, 3.23% of population suffer from diabetes, 92.5% of those has type 2 diabetes. Chronic course of diabetes is associated with the development of complications from target organs, among them the most common is diabetic nephropathy, which ranks second in frequency of occurrence, which is about 18.4%. Diabetic nephropathy is characterized by a variety of pathomorphological and pathophysiological changes in the renal tissue based on development of glomerulosclerosis. Prolonged functioning of kidneys filtering system in conditions of hyperglycemia leads to the chronic kidney disease development. Occurrence of this complication increases the risk of cardiovascular accidents in patients with diabetic nephropathy. Over time, chronic kidney disease in absence of appropriate treatment leads to development of terminal renal failure, which requires the use of renal replacement therapy. In this connection, prescription of appropriate antidiabetic therapy, competence of primary health care specialists (general practitioners, endocrinologists) in issues of modern appropriate antidiabetic therapy possibilities in chronic kidney disease conditions will allow to stop the process of disease progression and postpone the beginning of renal replacement therapy as much as possible. The article presents a review of modern Russian and foreign medical literature, concerning the aspects of glucose-lowering therapy for type 2 diabetes mellitus in patients with diabetic nephropathy complicated by chronic kidney disease.