TY - JOUR
T1 - Anti-diabetes therapy
T2 - Safety considerations for patients with impaired kidney function
AU - Mcgill, Janet B.
N1 - Funding Information:
Medical writing support for the preparation of this manuscript was provided by Valerie P. Zediak, PhD, and Judy Fallon, PharmD, CMPP, from Complete Healthcare Communications, Inc. (Chadds Ford, PA), with funding from Bristol-Myers Squibb and AstraZeneca LP.
Publisher Copyright:
© Postgraduate Medicine.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - The presence of type 2 diabetes mellitus (T2DM) is a common risk factor for the development of chronic kidney disease, but appropriate glycemic control can slow the progression of kidney dysfunction in patients with T2DM. The kidney plays a role in insulin resistance and gluconeogenesis, therefore, impaired kidney function alters glucose dynamics compared with normal kidney function, thus affecting antihyperglycemic treatment strategies. Glycemic management is further complicated by reduced drug clearance and a greater risk of hypoglycemia with use of certain medications, notably the sulfonylureas. Of the classes of antihyperglycemic drugs discussed in this review, caution is advised when using some classes in patients with T2DM and kidney disease.
AB - The presence of type 2 diabetes mellitus (T2DM) is a common risk factor for the development of chronic kidney disease, but appropriate glycemic control can slow the progression of kidney dysfunction in patients with T2DM. The kidney plays a role in insulin resistance and gluconeogenesis, therefore, impaired kidney function alters glucose dynamics compared with normal kidney function, thus affecting antihyperglycemic treatment strategies. Glycemic management is further complicated by reduced drug clearance and a greater risk of hypoglycemia with use of certain medications, notably the sulfonylureas. Of the classes of antihyperglycemic drugs discussed in this review, caution is advised when using some classes in patients with T2DM and kidney disease.
KW - Chronic kidney disease
KW - Clinical management
KW - Incretin therapy
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=84906926149&partnerID=8YFLogxK
U2 - 10.3810/pgm.2014.05.2765
DO - 10.3810/pgm.2014.05.2765
M3 - Article
C2 - 24918801
AN - SCOPUS:84906926149
SN - 0032-5481
VL - 126
SP - 161
EP - 171
JO - Postgraduate medicine
JF - Postgraduate medicine
IS - 3
ER -