ABSTRACT
BACKGROUND: Diabetic kidney disease is the leading cause of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) worldwide. ESKD has a high prevalence in patients with diabetes mellitus (DM). CKD increases the chances of hypoglycaemia by different mechanisms, causes insulin resistance and a decrease in insulin metabolism. Both the "Kidney Disease: Improving Global Outcomes" (KDIGO) and "American Diabetes Association" (ADA) guidelines recommend the use of insulin as part of treatment, but the type of basal insulin is not specified. METHODS: We reviewed the literature to determine whether first- and second-generation basal insulins are effective and safe in CKD patients. We reviewed specific pivotal studies conducted by pharmaceutical laboratories, as well as independent studies. CONCLUSIONS: Basal insulins are safe and effective in patients with CKD and diabetes mellitus but we do not have specific studies. Given that CKD is one of the main complications of type 2 DM, and insulin specific treatment in the final stages, the absence of studies is striking. Real-life data are also important since trials such as pivotal studies do not fully represent actual patients. Treatment should be individualized until we have specific trials in this type of population.
Subject(s)
Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/complications , Insulin/analogs & derivatives , Kidney/physiopathology , Renal Insufficiency, Chronic/etiology , Diabetes Mellitus, Type 2/epidemiology , Diabetic Nephropathies/epidemiology , Disease Progression , Global Health , Humans , Hypoglycemic Agents/antagonists & inhibitors , Incidence , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/physiopathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Arthritis , Edema , Muscle Weakness , Rheumatoid Factor , Tenosynovitis , Arthritis/blood , Arthritis/diagnosis , Arthritis/therapy , Edema/blood , Edema/diagnosis , Edema/therapy , Muscle Weakness/blood , Muscle Weakness/diagnosis , Muscle Weakness/therapy , Pelvic Bones , Scapula , Syndrome , Tenosynovitis/blood , Tenosynovitis/diagnosis , Tenosynovitis/therapyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Diabetic Ketoacidosis/drug therapy , Renal Insufficiency/complications , Dehydration/chemically induced , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Canagliflozin/adverse effects , Dehydration/complications , Canagliflozin/therapeutic use , Heart Rate , Linagliptin/administration & dosage , Metformin/administration & dosage , Insulin Glargine/administration & dosage , Insulin/administration & dosageABSTRACT
OBJECTIVE: Dulaglutide is an agonist of "glucagon-like peptide type 1â³ receptors (arGLP1). The clinical efficacy of this molecule is based on reductions in glycosylated hemoglobin (HbA1c) and weight, data shown in the pivotal AWARD studies. METHODS: We propose a retrospective and multicenter study that allows evaluating the effectiveness of dulaglutide at 24â¯months after treatment began, under conditions of usual clinical practice, and comparing the results obtained with those that are reflected in the controlled trials. RESULTS: The results show a reduction in the HbA1c levels -1.4% at 6â¯M and this reduction were maintained throughout 12â¯M and 24â¯M (pâ¯<â¯0.001). Plasma glucose showed significant reductions around -30â¯mg / dL at 6â¯months (pâ¯<â¯0.001) that remained until the end of the follow-up at 12 and 24â¯M, respectively. The weight decreased significantly at 6â¯M (pâ¯<â¯0.001) but continued decreasing at 12 and 24â¯M, showing statistically significant differences (p: 0.001). CONCLUSIONS: Our results are similar to those obtained in pivotal clinical trials and confirm these benefits in real life.
Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Glucagon-Like Peptides/analogs & derivatives , Hypoglycemic Agents/therapeutic use , Immunoglobulin Fc Fragments/therapeutic use , Recombinant Fusion Proteins/therapeutic use , Female , Glucagon-Like Peptides/pharmacology , Glucagon-Like Peptides/therapeutic use , Humans , Hypoglycemic Agents/pharmacology , Immunoglobulin Fc Fragments/pharmacology , Male , Middle Aged , Recombinant Fusion Proteins/pharmacology , Retrospective Studies , Time Factors , Treatment OutcomeSubject(s)
Acute Kidney Injury/chemically induced , Canagliflozin/adverse effects , Dehydration/chemically induced , Diabetes Mellitus, Type 2/complications , Diabetic Ketoacidosis/chemically induced , Sodium-Glucose Transporter 2 Inhibitors/adverse effects , Aged , Diabetes Mellitus, Type 2/drug therapy , Drug Substitution/adverse effects , Female , Humans , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/therapeutic use , Insulin/adverse effects , Insulin/therapeutic use , Syncope/chemically inducedSubject(s)
Renal Insufficiency, Chronic , Sodium-Glucose Transporter 2 Inhibitors , Glucose , Humans , Inflammation , SodiumABSTRACT
No disponible
Subject(s)
Humans , Interviews as Topic , Medical Records , Cell Phone Use , Notification , Emergency Medical Services/statistics & numerical data , Informed Consent/standardsSubject(s)
Arthritis , Edema , Muscle Weakness , Rheumatoid Factor , Tenosynovitis , Aged , Arthritis/blood , Arthritis/diagnosis , Arthritis/therapy , Edema/blood , Edema/diagnosis , Edema/therapy , Humans , Male , Muscle Weakness/blood , Muscle Weakness/diagnosis , Muscle Weakness/therapy , Pelvic Bones , Scapula , Syndrome , Tenosynovitis/blood , Tenosynovitis/diagnosis , Tenosynovitis/therapySubject(s)
Cell Phone , Medical History Taking , Physician-Patient Relations , Age Factors , Attention , Communication Barriers , Ethnicity , Female , Humans , Male , Sex Factors , TriageABSTRACT
No disponible
