Decision letter for "Chronic Kidney Disease in Type 2 Diabetes: Implications for Managing Glycemic Control, Cardiovascular & Renal Risk"

2019 ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control

scholarly journals Prevalence of chronic kidney disease stages 3-5 among patients with type 2 diabetes mellitus in Bangladesh

2017 ◽  
Vol 11 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Palash Mitra ◽  
Hasna Fahmima Haque ◽  
Tasrina Shamnaz Samdani ◽  
Shahana Zaman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Significant Risk ◽  
Duration Of Diabetes

Background and objectives: Diabetes mellitus is one of the most common causes of chronic kidney disease (CKD). The prevalence of CKD in type 2 diabetes mellitus (T2DM) in Bangladesh is not well described. The present study aimed to find out the prevalence of CKD stages 3-5 and its risk factors among selected Bangladeshi T2DM patients.Methods: This cross-sectional study was conducted in BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital, Dhaka, Bangladesh from July to December 2015. Diagnosed adult T2DM patients were consecutively and purposively included in this study. Pregnant women, patients with diagnosed kidney disease due to non-diabetic etiology, acute kidney injury (AKI), AKI on CKD and patients on renal replacement therapy were excluded. Age, gender, body mass index (BMI) and laboratory parameters were recorded systematically in a predesigned data sheet. Diagnosis of CKD and its stages were determined according to Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines 2012 and estimated glomerular filtration rate (eGFR). Estimated GFR was calculated by using Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG) and Chronic Kidney Disease Epidemiology (CKDEPI) creatinine based formula.Results: A total of 400 patients with T2DM of various durations were enrolled in the study. Out of 400 patients, 254 (63.5%), 259 (64.75%) and 218 (54.5%) cases had CKD stages 3-5 according to MDRD, C-G and CKD-EPI equations respectively. CKD was significantly more common in females (p<0.001) and in cases with long duration of diabetes (?5 years; p=0.007). CKD stages 3-5 were significantly associated with hypertension (?2=5.2125, p =0.02) and good control of diabetes (HbA1c <7%) as evidenced by higher proportion of CKD in them (73.3%) compared to those with poor glycemic control (52.1%).Conclusions: More than half of T2DM patients had CKD stages 3-5. Female gender, duration of diabetes and hypertension were significant risk factors and should be emphasized for the prevention of CKD in T2DM. Glycemic control may not reduce CKD in diabetes.IMC J Med Sci 2017; 11(1): 19-24

scholarly journals Study of correlation between adequacy of dialysis and glycemic control in patients of type 2 diabetes mellitus with chronic kidney disease stage 5

2020 ◽  
Vol 8 (4) ◽  
pp. 1366
Author(s):  
Samrat Mitra ◽  
Sanghita Barui
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Random Blood Sugar

Background: The adequacy of haemodialysis in patients of type 2 diabetes mellitus with chronic kidney disease stage 5 depends on several clinical as well as laboratory parameters. Previous studies from Western literature have identified several clinical and laboratory markers for predicting adequacy of dialysis. There is a dearth of literature regarding the same in Indian patient populace. Authors aimed to find correlation, if any, between glycemic control and adequacy of dialysis in this cohort of patients.Methods: A set of 200 patients of type 2 diabetes mellitus who have undergone hemodialysis at a tertiary care hospital were included in the study. Random blood sugar (RBS), Glycated hemoglobin (HbA1c) were measured at admission. After 4 hours of dialysis, the urea reduction ratio (URR) and Kt/V was measured for each patient. The correlation coefficient as well as linear equation of the association between these variables were calculated. Standard statistical method and software were used in the process.Results: The study revealed a linear negative correlation between the variables RBS, HbA1c and URR as well as Kt/V. This suggests the importance of pre dialysis glycemic control in patients undergoing hemodialysis.Conclusions: Authors formulate the hypothesis that glycated hemoglobin and random blood sugar at admission correlate well with the outcome and adequacy of dialysis in patients of stage 5 chronic kidney disease undergoing haemodialysis.  Good glycemic control (HbA1c <6.5 % and RBS <120 mg/dL) have shown to be important predictive markers of adequate dialysis. The hypothesis needs to be tested with a larger study.

scholarly journals The role of sodium-glucose cotransporter 2 inhibitors in the treatment of type 2 diabetes: from clinical research to real practice

2020 ◽  
Vol 48 ◽  
Author(s):  
I. V. Misnikova ◽  
Yu. A. Kovaleva ◽  
V. A. Gubkina
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Insulin Dose ◽  
Therapy Regimen ◽  
Sodium Glucose Cotransporter

In type 2 diabetes mellitus (T2DM), the development and progression of cardiovascular diseases occurs, which allows it to be considered as a cardiorenal metabolic syndrome. This should be taken into account when choosing hypoglycemic drugs. Patients with T2DM receiving insulin therapy often have a long history of diabetes, cardiovascular disease, chronic kidney disease, obesity, and need to be prescribed high doses of insulin and/or complex insulin therapy regimens to maintain glycemic control, which does not always lead to the achievement of target levels of glycemia and glycated hemoglobin (HbA1c). Adding to any insulin therapy regimen drugs from the class of sodium-glucose cotransporter type 2 inhibitors (SGLT-2), which have proven their cardio- and renoprotective properties, seems to be a rational combination in patients with T2DM and may have a number of advantages. The article presents 4 clinical examples of dapagliflozin administration, a drug from the SGLT2 class, to patients who are on insulin therapy, having T2DM with a  long history (10–26 years), as well as cardiovascular diseases, chronic kidney disease, and obesity. Dapagliflozin administration allowed to improve glycemic control, to stabilize the insulin dose, as well as reduce body weight without increasing the frequency of serious episodes of hypoglycemia in patients who initially received large doses of insulin. In the long term, we can expect reduction of the progression of cardiovascular risks and the risks of hospitalization due to existing complications of the disease.

2352-PUB: Level of Glycemic Control in Type 2 Diabetes (T2D) Patients with Established Cardiovascular Disease (eCVD) or Chronic Kidney Disease (CKD) Prescribed an SGLT2i

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2352-PUB
Author(s):  
KRISTY IGLAY ◽  
NEHA BANSAL ◽  
TANIA GULATI ◽  
HAKIMA HANNACHI ◽  
GAIL FERNANDES ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control
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