scholarly journals Utilization of glucagon‐like peptide‐1 receptor agonists and changes in clinical characteristics in type 2 diabetes mellitus patients by chronic kidney disease stage in Japan: A descriptive observational study using nationwide electronic medical record databases

Author(s):  
Naoki Hirose ◽  
Naoto Tsujimoto ◽  
Taeko Katayose ◽  
Rina Chin
2021 ◽  
Vol 17 (8) ◽  
pp. 624-632
Author(s):  
V.I. Katerenchuk

The article presents the literature review of the possibilities of modern antidiabetic therapy in the prevention of chronic kidney disease in patients with type 2 diabetes mellitus. The mechanisms of development and features of kidney disease in type 2 diabetes mellitus are described. The results of most recent clinical trials for studying the possibility of nephroprotection with new groups of hypoglycemic agents are reviewed: dipeptidyl peptidase-4 inhi-bitors, glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors. The advantages of usage and the nephroprotective effects of agonists of glucagon-like peptide-1 receptors and sodium-glucose loop cotransporter-2 inhibitors are determined. Particular attention is paid to the nephroprotective effect of sodium-glucose loop co-transporter inhibitors as the only class of drugs that have demonstrated a reduction in the rate of decrease in glomerular filtration rate in patients with diabetes. The expediency of further study of the efficacy of the combined use of sodium-glucose cotransporter-2 inhibitors and agonists of glucagon-like peptide-1 receptors in diabetic chronic kidney disease is indicated. For a long time, approaches to the treatment of diabetic kidney disease did not differ for patients with type 1 and type 2 diabetes. The stu­dies of recent years have shown that new hypoglycemic drugs can not only lower blood glucose levels but also have a beneficial effect on renal function. The mechanisms of nephroprotective effects have not been fully studied, but it is clear that they are beyond the scope of improved glycemic control. The possibility of the nephroprotective effect of these drugs on a glomerular filtration rate in the range of 30–15 ml/min/1.73 m2 and below remains unexplored. The effect of the combined use of glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors is also unclear: will this combination predominate over monotherapy, and, if so, to what extent?


Author(s):  
Samrat Mitra ◽  
Sanghita Barui

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.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 487-P
Author(s):  
KOHTAROH MIYAMOTO ◽  
AKIRA KOSEKI ◽  
MICHIHARU KUDO ◽  
MASAKI MAKINO ◽  
ATSUSHI SUZUKI

2019 ◽  
Vol 51 (7) ◽  
pp. 1229-1230
Author(s):  
Ravindra Attur Prabhu ◽  
Aswani Srinivas Mareddy ◽  
Shankar Prasad Nagaraju ◽  
Dharshan Rangaswamy ◽  
Vasudeva Guddattu

2018 ◽  
Vol 12 (4) ◽  
pp. 202-209 ◽  
Author(s):  
Spyridon N. Karras ◽  
Eleni Rapti ◽  
Theocharis Koufakis ◽  
Angeliki Kyriazou ◽  
Dimitrios G. Goulis ◽  
...  

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