Protecting the Kidneys: Update on Therapies to Treat Diabetic Nephropathy.

This article provides an update on pharmacotherapy for diabetic nephropathy. ACE inhibitor or angiotensin 2 receptor blocker therapy is a standard of care for hypertension management in people with diabetes and albuminuria. Additionally, recent trials have elucidated the roles of additional therapeutic agents, including the sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and the recently approved mineralocorticoid receptor antagonist finerenone, in the treatment of chronic kidney disease in people with type 2 diabetes. This article provides an evidence-based review of therapies that may delay the progression of kidney disease in this population, including discussion of recent outcomes trials.

Evaluation of a Pharmacist-Managed Diabetes Transitions of Care Medication Management Clinic.

PURPOSE: The purpose of this study was to determine the impact of a pharmacist-managed transitions of care (TOC) clinic on outcomes in a posthospitalization population with diabetes. METHODS: A retrospective single center cohort study utilized electronic health records to identify discharged patients followed by the inpatient endocrinology team. The primary outcome was 30-day readmission rates in the target population. Secondary outcomes include 90-day readmission rates, time to first follow-up, emergency department/urgent care encounters, change in A1C, retention with endocrinology, referrals for diabetes education, and types of interventions. The control group included patients prior to the initiation of the TOC clinic compared to patients seen in the TOC clinic, evenly matched by A1C. Readmission rates and other clinical data were queried up to 4 months after discharge. RESULTS: Patients in the TOC cohort had similar 30-day readmission rates compared to the non-TOC cohort and were found to have lower A1C values within 120 days of discharge. Overall, patients in the TOC cohort were more likely to have a follow-up appointment and had closer follow-up after discharge. CONCLUSION: This study highlights that although there was no difference in readmission rates, a pharmacist-managed diabetes TOC clinic may decrease time to follow-up and improve long-term diabetes outcomes.