Type 2 diabetes mellitus management in patients with chronic kidney disease: an update.

Type 2 diabetes mellitus management in patients with chronic kidney disease: an update. Hormones (Athens). 2020 Jun 04;: Authors: Kleinaki Z, Kapnisi S, Theodorelou-Charitou SA, Nikas IP, Paschou SA Abstract Diabetes mellitus (DM) is a chronic multisystem disease. Diabetic nephropathy (DN) is one of its significant microvascular complications, associated with increased morbidity and mortality. The aim of this article is to review the literature regarding the latest advances in the management of type 2 DM (T2DM) in patients with chronic kidney disease (CKD). We initially refer to the screening guidelines, the diagnostic tests used, the need for novel biomarkers in DN, the recent advances in high-risk patient identification, the recommended glycemic targets, and concerns regarding the accuracy of HbA1c in these patients. Then, a detailed explanation of the appropriate medical management based on evidence from recent trials is presented, analyzed, and discussed. All patients with T2DM should be screened for albuminuria at initial diagnosis and annually thereafter. Proteomics and metabolomics today represent promising diagnostic tools. Optimal glycemic control, with individualized HbA1c targets, is fundamental for reduced onset or delayed progression of DN and microvascular complications, in general. This can be enhanced by lifestyle modifications and pharmacological interventions when needed. Metformin represents the first pharmacological step, with, recentl...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research

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ConclusionsCKD due to T2DM had been the main contributor to the increasing burden of CKD over the past several decades. We suggest a more ‐pragmatic approach focusing on early diagnosis, primary care, and adequate follow‐up to reduce mortality and the long‐term burden in low to middle SDI regions. Interventions should address high systolic blood pressure as well as overweight and obesity problems, especially in high‐income reg ions.
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Authors: Zizzi CF, Pellicano R, Biancone L Abstract A number of studies has confirmed that the epidemiology of Helicobacter pylori (H. pylori) is changing worldwide, with a decrease especially in developed Countries. Nevertheless, since this Gram-negative bacterium infects almost 50% of the world's population, it remains a global problem. Beyond its role in the pathogenesis of the main gastroduodenal diseases, including gastritis, peptic ulcer and gastric cancer, H. pylori has been suspected to be involved in several extra-gastroduodenal disorders. Patients with chronic kidney disease (CKD) present gastric mucosal ...
Source: Minerva Gastroenterologica e Dietologica - Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research
ConclusionLiraglutide may prevent many fatal and non-fatal CVD events if provided to US adults meeting LEADER eligibility criteria. More efforts are needed to educate the healthcare providers on the CVD benefits from newer diabetes therapies, including liraglutide.
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
High burden of chronic cardio-metabolic disorders including type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and cardiovascular disease (CVD) have been reported in the Middle East and North Afric...
Source: Journal of Translational Medicine - Category: Research Authors: Tags: Research Source Type: research
A 78-year-old woman with a history of type 2 diabetes mellitus, chronic kidney disease stage 4, hypertension, atrial fibrillation, grade 1 follicular lymphoma, gastroesophageal reflux disease, and iron deficiency anemia presented with several months of transfusion-dependent anemia. Medications included oral ferrous sulfate, insulin, spironolactone, clonidine, metoprolol, simvastatin, omeprazole, and apixaban. In the past several months, she had been receiving weekly darbepoetin alfa injections and requiring 4 blood transfusions a month.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Medical image Source Type: research
Fungal skull-base osteomyelitis of the temporal bone is an extremely rare condition associated with significant morbidity and mortality. Challenges in diagnosis, specifically accurate identification of pathogens, can complicate and delay appropriate treatment. This is a case of an 82-year-old man with a history of chronic kidney disease, prostate cancer, and type 2 diabetes mellitus. He had a history Bell palsy with complete facial paralysis 1 year prior and a 9-month history of worsening otalgia and otorrhea. Noncontrast computed tomography of the temporal bone revealed a well-developed, opacified mastoid with bone erosio...
Source: Infectious Diseases in Clinical Practice - Category: Infectious Diseases Tags: Case Reports Source Type: research
Conclusions: The present study showed a significant prevalence of DM-related amputations. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM. PMID: 32545366 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
AbstractBackgrounds and objectsSodium ‐glucose cotransporter 2 inhibitors (SGLT2i) improve renal outcome in patients with type 2 diabetes mellitus, but the mechanism isn’t fully understood. The aim of this retrospective study is to assess the association of achieved blood pressure with renal outcomes in Japanese type 2 diabetes mell itus patients with chronic kidney disease.MethodsWe assessed 624 Japanese type 2 diabetes mellitus patients with chronic kidney disease on SGLT2i for>1 year. The patients were classified as those with post ‐treatment mean arterial pressure (MAP) of ≥92 mmHg (n=344) and those with MAP of
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conditions:   Chronic Kidney Diseases;   Type 2 Diabetes Intervention:   Sponsor:   Medlior Health Outcomes Research Ltd Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Endothelial Progenitor cells (EPCs) has been shown to be dysfunctional in both type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) leading to poor regeneration of endothelium and renal perfusion. ...
Source: Cardiovascular Diabetology - Category: Cardiology Authors: Tags: Original investigation Source Type: research
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