Glycemic Control in Patients with Diabetic Kidney Disease; Time to Recognize Perils of Iatrogenic Hypoglycemia?Moving away from Intensive Glycemic Control.

Glycemic Control in Patients with Diabetic Kidney Disease; Time to Recognize Perils of Iatrogenic Hypoglycemia?Moving away from Intensive Glycemic Control. J Assoc Physicians India. 2018 Sep;66(9):70-75 Authors: Gupta P, Gupta R, Gupta AK Abstract The chronic complications of Diabetes Mellitus (DM), which may be present in as many as 50% of the patients at the time of diagnosis, are a major burden for both individuals with the disease and health systems and it has been estimated that as much as 60-70% of healthcare expenditure related to diabetes (about 670 billion dollars a year) is currently attributable to chronic complications of the disease. These high prevalence rates are widely acknowledged to further rise as poor lifestyle choices and their consequences continue to rise. Adding to that is an aging population and urbanization that together will make situation even more challenging. Type 2 diabetes affects about 90-95% of newly diagnosed patients of diabetes and accounts for majority of cases of Chronic Kidney Disease (CKD). In other words, CKD affects about 20-40% of individuals with diabetes making it one of the most common complication related to the disease. The risk of renal failure is 25 times higher in diabetic patients than in the non-diabetic population. Thus patients with diabetes and renal failure represent a special risk group as they have higher morbidity and mortality and are at a higher risk of hypoglycaemia than diabetic individuals ...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research

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Dominique E. Martin1,2, Amanda K. Jones1,3, Sambhu M. Pillai1,4, Maria L. Hoffman1,5, Katelyn K. McFadden1,6, Steven A. Zinn1, Kristen E. Govoni1 and Sarah A. Reed1* 1Department of Animal Science, University of Connecticut, Storrs, CT, United States 2Department of Psychology, Providence College, Providence, RI, United States 3Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Aurora, CO, United States 4School of Medicine, Georgetown University, Washington, DC, United States 5Department of Fisheries, Animal and Veterinary Sciences, The University of Rhode Island, Kingston, RI, United St...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
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Source: Frontiers in Physiology - Category: Physiology Source Type: research
Conclusion As a critical regulator of inflammation and cell survival, the NFκB pathway is a promising target for diagnosing and treating kidney diseases. For modulation of the NFκB pathway in the clinic, a number of molecules can effectively inhibit NFκB signaling by targeting the receptors, associated adaptors, IKKs, IκBs and transcriptional regulators (144). There is further clinical evidence on small-molecule inhibitors of IKKα and NIK from recent trials on anti-cancer therapies (145). These clinical trials showed that the cancer-selective pharmacodynamic response of DTP3, the co-inhibitor...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Authors: Roumeliotis A, Roumeliotis S, Panagoutsos S, Theodoridis M, Argyriou C, Tavridou A, Georgiadis GS Abstract BACKGROUND: Intima-Media-Thickness of the carotid artery wall (cIMT) is a strong predictor of cardiovascular (CV) disease. The aim of this study was to investigate the significance of cIMT as an independent prognostic factor for CV morbidity and mortality in patients with chronic kidney disease (CKD) and diabetes mellitus type 2 (DM2). METHODS: The study included 142 diabetic patients in different stages of CKD. Patients were categorized into two groups according to low (≤0.86 mm) or hig...
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
CONCLUSIONS: CKD is frequent in the diabetic population ≥ 65 years of age and is associated with elderly age, high comorbidity and with treated hypertension. No relationship has been found with gender and time in years since onset of diabetes. PMID: 29428153 [PubMed - as supplied by publisher]
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
Chronic kidney disease (CKD) affects a substantial minority of people with type 2 diabetes (T2D). Analysis of US National Health and Nutrition Examination Survey (NHANES) datasets from 2007 through 2012 showed Stage 3 or worse disease (estimated glomerular filtration rate [eGFR]
Source: Journal of Diabetes - Category: Endocrinology Authors: Tags: Editorial Source Type: research
Publication date: Available online 6 December 2017 Source:Pharmacological Research Author(s): Giuseppe Coppolino, Christian Leporini, Laura Rivoli, Francesco Ursini, Eugenio Donato di Paola, Valeria Cernaro, Franco Arturi, Davide Bolignano, Emilio Russo, Giovambattista De Sarro, Michele Andreucci Dipeptidyl-peptidase-4 (DPP-4) inhibitors are a relatively new class of non-insulin glucose-lowering agents, belonging to the incretin family, which are able to improve glycemic control with a favorable safety profile, since they are associated with a low risk of hypoglycemia, no weight gain, and good tolerability in patients wit...
Source: Pharmacological Research - Category: Drugs & Pharmacology Source Type: research
Abstract Metformin as an oral antidiabetic drug (OAD) is not recommended in renal failure due to the presumed risk of lactic acidosis though it has advantages in cardiovascular protection with a low risk of hypoglycemia. Few studies have measured lactic acid blood levels in patients with diabetic kidney disease on metformin and demonstrated lactic acidosis. The aim of our study is to see if patients with diabetic kidney disease are at risk of elevated lactate blood levels and lactic acidosis. Lactate levels and blood pH were estimated in patients with type 2 diabetes mellitus receiving metformin in different stage...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
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Source: Journal of Inherited Metabolic Disease - Category: Internal Medicine Source Type: research
AbstractDiabetes is the leading cause of chronic kidney disease, and even in the absence of albuminuria, decreased renal function in type 2 diabetes mellitus (T2DM) patients increases the risk for major adverse cardiovascular events and death. The evidence derived from recent studies suggests that intensive glucose control not only reduces the risk for microalbuminuria and macroalbuminuria but may also decrease the rate of decline of glomerular filtration rate (GFR). Although insulin therapy is widely used in patients with T2DM and renal disease, metabolic control is particularly difficult to achieve and manage because of ...
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
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