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 pharmacologic...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research