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The kidney and cardiovascular outcome trials
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] <60 mL/min per 1.73 m2) in nearly one in five patients, with increasing age, blood pressure, obesity, and levels of glycemia all associated with higher likelihood of Stage 3 or worse CKD, comparable to findings from surveys from many other areas, which also show micro‐ or macroalbuminuria to be present in one‐sixth to one‐third of diab...
Source: Journal of Diabetes - January 19, 2018 Category: Endocrinology Authors: Zachary Bloomgarden Tags: Editorial Source Type: research

Can we go beyond surrogates?
Two years ago, data presented at the annual American Diabetes Association (ADA) meeting in New Orleans showed a marked decrease in deaths, especially those due to cardiovascular disease, with the use of empagliflozin. Two major questions have been asked: (i) was the result a fluke; and (ii) was it a class effect, or was it specific to the agent used? The hope that both questions would be answered by a second study has been answered: the conclusions of EMPA‐REG were not an anomaly and it is a class effect, not one caused by a specific drug. Importantly, do these studies require us to alter our algorithms for the treatment...
Source: Journal of Diabetes - October 19, 2017 Category: Endocrinology Authors: Andrew Drexler Tags: Editorial Source Type: research