scholarly journals La gestione della terapia ipoglicemizzante nel paziente con nefropatia da diabete mellito tipo 2

2019 ◽  
Vol 31 (3) ◽  
pp. 155-159
Author(s):  
Francesco Manetti

Management of hypoglycemic therapy in patients with type 2 diabetes mellitus and nephropathy Chronic kidney disease (CKD) is constantly increasing in terms of prevalence and incidence. Subjects with impaired renal function, even if only in the presence of micro/macroalbuminuria, have an increased cardiovascular risk profile. Therefore, we must pay particular attention to the treatment of all associated risk factors. Therapy with oral hypoglycemic agents often requires modulation of drug dosage based on kidney function. Today, there are molecules available that are able not only to induce cardiovascular protection, but also to slow the progression of renal damage.

2019 ◽  
Vol 31 (3) ◽  
pp. 155-159
Author(s):  
Francesco Manetti

Chronic kidney disease (CKD) is constantly increasing in terms of prevalence and incidence. Subjects with impaired renal function, even if only in the presence of micro/macroalbuminuria, have an increased cardiovascular risk profile. Therefore, we must pay particular attention to the treatment of all associated risk factors. Therapy with oral hypoglycemic agents often requires modulation of drug dosage based on kidney function. Today, there are molecules available that are able not only to induce cardiovascular protection, but also to slow the progression of renal damage.


2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Shuo Lin ◽  
Mu Chen ◽  
Wanling Chen ◽  
Keyi Lin ◽  
Panwei Mu ◽  
...  

Aims. Basal insulin plus oral hypoglycemic agents (OHAs) has not been investigated for early intensive antihyperglycemic treatment in people with newly diagnosed type 2 diabetes. This study is aimed at comparing the short-term (over a period of 12 days) effects of basal insulin glargine plus OHAs and continuous subcutaneous insulin infusion (CSII) on glycemic control and beta-cell function in this setting. Methods. An open-label parallel-group study. Newly diagnosed hospitalized patients with type 2 diabetes and fasting plasma glucose (FPG) ≥11.1 mmol/L or glycated hemoglobin (HbA1c) ≥9% (75 mmol/mol) were randomized to CSII or insulin glargine in combination with metformin and gliclazide. The primary outcome measure was the mean amplitude of glycemic excursions (MAGE), and secondary endpoints included time to reach glycemic control target (FPG < 7 mmol/L and 2-hour postprandial plasma glucose < 10 mmol/L), markers of β-cell function, and hypoglycemia. Results. Subjects in the CSII (n=35) and basal insulin plus OHA (n=33) groups had a similar significant reduction from baseline to end of treatment in glycated albumin (−6.44 ± 3.23% and− 6.42 ± 3.56%, P=0.970). Groups A and B have comparable time to glycemic control (3.6 ± 1.2 days and 4.0 ± 1.4 days), MAGE (3.40 ± 1.40 mmol/L vs. 3.16 ± 1.38 mmol/L; p=0.484), and 24-hour mean blood glucose (7.49 ± 0.96 mmol/L vs. 7.02 ± 1.03 mmol/L). Changes in the C-peptide reactivity index, the secretory unit of islet in transplantation index, and insulin secretion-sensitivity index-2 indicated a greater β-cell function improvement with basal insulin plus OHAs versus CSII. Conclusions. Short-term insulin glargine plus OHAs may be an alternative to CSII for initial intensive therapy in people with newly diagnosed type 2 diabetes.


2014 ◽  
Vol 42 (2) ◽  
pp. 63-71 ◽  
Author(s):  
Heather F. de Vries McClintock ◽  
Knashawn H. Morales ◽  
Dylan S. Small ◽  
Hillary R. Bogner

2012 ◽  
Vol 58 (3) ◽  
pp. 56-60
Author(s):  
I R Iarek-Martynova

The onset of insulin therapy is an important stage in the treatment of type 2 diabetes mellitus. Its timely beginning ensures better control of glycemia and reduces the negative consequences of chronic glucose cytotoxicity and lipotoxicity. The achievement and maintenance of the stable compensation of the disease are the indispensable conditions for successful prophylaxis and adequate treatment of chronic complications of diabetes mellitus. The ADA guidelines recommend to initiate insulin therapy at the early stages of the disease provided it is dictated by the clinical situation or combine it with the use of oral hypoglycemic agents if the targeted HbA1c levels fail to be reached despite the intake of one or more tableted preparations.


2008 ◽  
Vol 10 (5) ◽  
pp. 397-403 ◽  
Author(s):  
C.Y. Pan ◽  
L.T. Ho ◽  
S. Soegondo ◽  
W. Prodjosudjadi ◽  
S. Suwanwalaikorn ◽  
...  

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