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hypoglycemia in chronic kidney disease

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https://www.readbyqxmd.com/read/28758978/dietary-approaches-in-the-management-of-diabetic-patients-with-kidney-disease
#1
REVIEW
Gang Jee Ko, Kamyar Kalantar-Zadeh, Jordi Goldstein-Fuchs, Connie M Rhee
Chronic kidney disease (CKD) is one of the most prevalent complications of diabetes, and patients with diabetic kidney disease (DKD) have a substantially higher risk of cardiovascular disease and death compared to their non-diabetic CKD counterparts. In addition to pharmacologic management strategies, nutritional and dietary interventions in DKD are an essential aspect of management with the potential for ameliorating kidney function decline and preventing the development of other end-organ complications. Among DKD patients with non-dialysis dependent CKD, expert panels recommend lower dietary protein intake of 0...
July 31, 2017: Nutrients
https://www.readbyqxmd.com/read/28721081/insulin-glargine-300-u-ml-for-basal-insulin-therapy-in-type-1-and-type-2-diabetes-mellitus
#2
REVIEW
Ip Tim Lau, Ka Fai Lee, Wing Yee So, Kathryn Tan, Vincent Tok Fai Yeung
OBJECTIVE: To review published clinical studies on the efficacy and safety of new insulin glargine 300 units/mL (Gla-300), a new long-acting insulin analog, for the treatment of type 1 and type 2 diabetes mellitus (T1DM, T2DM). MATERIALS AND METHODS: Data sources comprised primary research articles on Gla-300, including pharmacodynamic, pharmacokinetic, and clinical studies. RESULTS: In pharmacodynamic and pharmacokinetic studies, Gla-300 showed a flatter time-action profile and longer duration of action than Gla-100...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28686322/characteristics-of-frequent-emergency-department-users-with-type-2-diabetes-mellitus-in-korea
#3
Morena Ustulin, Junghoon Woo, Jeong-Taek Woo, Sang Youl Rhee
AIMS/INTRODUCTION: Frequent emergency department (ED) visitors are medically vulnerable subjects. We identified the characteristics of "frequent ED users" among Korean patients with type 2 diabetes mellitus (DM). MATERIALS AND METHODS: We used the Health Insurance Review and Assessment Service National Patient Sample HIRA-(NPS), which is a nationally representative sample. Subjects (n = 109,412) with type 2 DM as a primary or secondary diagnosis at one of their visits were included...
July 7, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28616207/changes-in-metformin-use-in-chronic-kidney-disease
#4
Talha H Imam
Metformin is one of the oldest and most widely prescribed antidiabetic medicines worldwide. It is the only such medicine that has shown a reduction of cardiovascular mortality in diabetes mellitus type 2. Since many diabetic patients have chronic kidney disease, its use is often curtailed by practitioners due to fear of lactic acidosis and the US Food and Drug Administration (FDA) warnings that, until recently, had been in place for decades. Current guidelines, though somewhat vague regarding dosages, clearly pave the way for spreading the use of metformin in patients with lower glomerular filtration rates...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28605603/efficacy-and-safety-of-degludec-versus-glargine-in-type-2-diabetes
#5
Steven P Marso, Darren K McGuire, Bernard Zinman, Neil R Poulter, Scott S Emerson, Thomas R Pieber, Richard E Pratley, Poul-Martin Haahr, Martin Lange, Kirstine Brown-Frandsen, Alan Moses, Simon Skibsted, Kajsa Kvist, John B Buse
Background Degludec is an ultralong-acting, once-daily basal insulin that is approved for use in adults, adolescents, and children with diabetes. Previous open-label studies have shown lower day-to-day variability in the glucose-lowering effect and lower rates of hypoglycemia among patients who received degludec than among those who received basal insulin glargine. However, data are lacking on the cardiovascular safety of degludec. Methods We randomly assigned 7637 patients with type 2 diabetes to receive either insulin degludec (3818 patients) or insulin glargine U100 (3819 patients) once daily between dinner and bedtime in a double-blind, treat-to-target, event-driven cardiovascular outcomes trial...
June 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28514729/meglitinides-increase-the-risk-of-hypoglycemia-in-diabetic-patients-with-advanced-chronic-kidney-disease-a-nationwide-population-based-study
#6
Pei-Chen Wu, Vin-Cent Wu, Cheng-Jui Lin, Chi-Feng Pan, Chih-Yang Chen, Tao-Min Huang, Che-Hsiung Wu, Likwang Chen, Chih-Jen Wu
The safety of short-acting meglitinides in diabetic patients with advanced chronic kidney disease (CKD) has not been widely reported.Diabetic patients with advanced CKD who had a serum creatinine level of > 6 mg/dL a hematocrit level of ≦ 28% and received erythropoiesis-stimulating agent treatment between 2000 and 2010, were included in this nationwide study in Taiwan.The outcomes of interest were defined as hypoglycemia and long-term mortality. The risks of hypoglycemia and death were analyzed using Cox proportional hazards models, with end-stage renal disease and anti-diabetic drugs as time-dependent variables...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28432745/safety-of-sitagliptin-in-patients-with-type-2-diabetes-and-chronic-kidney-disease-outcomes-from-tecos
#7
Samuel S Engel, Shailaja Suryawanshi, Susanna R Stevens, Robert G Josse, Jan H Cornel, Neli Jakuboniene, Axel Riefflin, Tsvetalina Tankova, Julio Wainstein, Eric D Peterson, Rury R Holman
AIMS: To characterize the incidence of diabetes-associated complications and assess the safety of sitagliptin in participants with chronic kidney disease (CKD) in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). MATERIALS AND METHODS: For participants with baseline eGFR measurements (n = 14,528), baseline characteristics and safety outcomes were compared for the CKD cohort (eGFR <60 mL/min per 1.73 m(2) ) versus those without CKD. Within the CKD cohort, the same analyses were performed comparing sitagliptin- and placebo-assigned participants...
April 22, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28405576/evaluation-of-anti-diabetic-activity-of-ahpl-aytab-0513-tablet-in-streptozotocin-induced-diabetes-in-rats
#8
Sanjay U Nipanikar, Soham S Chitlange, Dheeraj Nagore
BACKGROUND: Diabetes is a chronic, progressive disease associated with several complications leading to significant mortality and morbidity. Limitations and drawbacks of the conventional treatment generate need for safer, effective complimentary therapies to prevent complications, and maintain normoglycemic status. AIM AND OBJECTIVES: The aim of this study is to to evaluate antidiabetic activity of AHPL/AYTAB/0513 tablet alone, oral hypoglycemic agents (OHA[s]), and combination of AHPL/AYTAB/0513 tablet and OHA(s) in streptozotocin-induced diabetes in rats...
January 2017: International Journal of Pharmaceutical Investigation
https://www.readbyqxmd.com/read/28225432/the-use-of-dipeptidyl-peptidase-4-inhibitors-in-patients-with-type-2-diabetes-chronic-kidney-disease
#9
Polly A Bittle
There is a need for treatment options in patients with type 2 diabetes mellitus and kidney disease to achieve glucose targets without risk of hypoglycemia. This article describes management options for these patients using glucose-lowering therapies, in particular dipeptidyl peptidase-4 inhibitors.
June 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28217510/a-retrospective-study-on-epidemiology-of-hypoglycemia-in-emergency-department
#10
Juvva Gowtham Kumar, K P P Abhilash, Rama Prakasha Saya, Neeha Tadipaneni, J Maheedhar Bose
BACKGROUND: Hypoglycemia is one among the leading causes for Emergency Department (ED) visits and is the most common and easily preventable endocrine emergency. This study is aimed at assessing the incidence and elucidating the underlying causes of hypoglycemia. MATERIALS AND METHODS: A retrospective, observational study which included patients registering in ED with a finger prick blood glucose ≤60 mg/dl at the time of arrival. All patients aged above 15 years with the above inclusion criteria during the period of August 2010 to July 2013 were selected...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28178698/dipeptidyl-peptidase-4-inhibitors-in-chronic-kidney-disease-a-systematic-review-of-randomized-clinical-trials
#11
Simon R Walker, Paul Komenda, Suhail Khojah, Wafa Al-Tuwaijri, Kerry MacDonald, Brett Hiebert, Neil Tangri, Stewart W D Nadurak, Thomas W Ferguson, Claudio Rigatto, Navdeep Tangri
BACKGROUND: Chronic kidney disease (CKD) is common in patients with type 2 diabetes mellitus (T2DM) and limits therapeutic options. Dipeptidyl peptidase-4 (DPP-4) inhibitors represent a novel class of oral glucose-lowering agents and are known to be safe and effective in the general population. METHODS: We searched Cochrane, EMBASE, and PubMed from the time of their inception until March 2015. We included randomized controlled trials analyzing the efficacy (change in hemoglobin A1C [HbA1C]) and safety of DPP-4 agents in individuals with reduced kidney function (estimated glomerular filtration rate <60 mL/min/1...
2017: Nephron
https://www.readbyqxmd.com/read/28139970/hemodialysis-refractory-metformin-associated-lactate-acidosis-with-hypoglycemia-hypothermia-and-bradycardia-in-a-diabetic-patient-with-belated-diagnosis-and-chronic-kidney-disease%C3%A2
#12
Lada Zibar, Karin Zibar
Metformin is a first-line oral antidiabetic therapy for patients with type 2 diabetes mellitus. Metformin-associated lactate acidosis (MALA) is a well-known, life-threatening, but rare side effect of metformin therapy. Chronic kidney disease (CKD) patients have a much greater risk of MALA. We report the case of a severe refractory MALA despite hemodialysis (HD) treatment, associated with hypoglycemia, hypothermia, and bradycardia in a neglected and thus untimely-recognized CKD patient with type 2 diabetes mellitus...
April 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27977934/longer-term-safety-and-tolerability-of-canagliflozin-in-patients-with-type-2-diabetes-a-pooled-analysis
#13
Rong Qiu, Dainius Balis, John Xie, Michael J Davies, Mehul Desai, Gary Meininger
OBJECTIVE: To evaluate the longer-term safety of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, in patients with type 2 diabetes mellitus (T2DM). METHODS: The safety/tolerability of canagliflozin 100 and 300 mg were assessed using data pooled from seven placebo- and active-controlled studies of 52-104 weeks in duration that enrolled a broad range of patients with T2DM (N = 5598). Canagliflozin 100 and 300 mg as monotherapy or in combination with various background antihyperglycemic agents (AHAs) were compared with pooled non-canagliflozin treatments (i...
March 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27828844/association-of-self-reported-recurrent-mild-hypoglycemia-with-incident-cardiovascular-disease-and-all-cause-mortality-in-patients-with-type-2-diabetes-prospective-analysis-of-the-joint-asia-diabetes-evaluation-registry
#14
Andrea On Yan Luk, Tony S T Ho, Eric S H Lau, Gary T C Ko, Risa Ozaki, Chiu-Chi Tsang, Alice P S Kong, Ronald C W Ma, Wing-Yee So, Francis C C Chow, Juliana C N Chan
Severe hypoglycemia is an established risk marker for cardiovascular complications of diabetes, but whether mild hypoglycemia confers similar risks is unclear. We examined the association of self-reported recurrent mild hypoglycemic events with cardiovascular disease (CVD) and all-cause mortality in a prospective cohort of Chinese adults with type 2 diabetes.From June 2007 to May 2015, 19,019 patients in Hong Kong underwent comprehensive assessment of metabolic and complication status using the Joint Asia Diabetes Evaluation program...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27760420/risks-of-metformin-in-type-2-diabetes-and-chronic-kidney-disease-lessons-learned-from-taiwanese-data
#15
Connie M Rhee, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
Like other biguanide agents, metformin is an anti-hyperglycemic agent with lower tendency towards hypoglycemia compared to other anti-diabetic drugs. Given its favorable effects on serum lipids, obese body habitus, cardiovascular disease, and mortality, metformin is recommended as the first-line pharmacologic agent for type 2 diabetes in the absence of contraindications. However, as metformin accumulation may lead to type B non-hypoxemic lactic acidosis, especially in the setting of kidney injury, chronic kidney disease, and overdose, regulatory agencies such as the United States Food and Drug Administration (FDA) have maintained certain restrictions regarding its use in kidney dysfunction...
2017: Nephron
https://www.readbyqxmd.com/read/27759630/risk-of-hospitalization-for-hypoglycemia-among-older-korean-people-with-diabetes-mellitus-interactions-between-treatment-modalities-and-comorbidities
#16
MULTICENTER STUDY
Hyun Min Kim, Jong-Mi Seong, Jaetaek Kim
The objective of this study was to carry out a large population-based study to understand the factors associated with hypoglycemia-related hospitalizations among older Korean adults with diabetes mellitus.This study analyzed data from a subset of the 2013 Health Insurance and Review and Assessment service-Adult Patient Sample. A total of 307,170 subjects, comprising 41.7% men and 58.3% women, had diabetes mellitus. Hypertension (80.8%) was the most common comorbidity, and dyslipidemia (59.0%) and ischemic heart disease (21...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27721548/prescribing-patterns-of-medicines-in-chronic-kidney-disease-patients-on-maintenance-hemodialysis
#17
Sourav Chakraborty, Saugata Ghosh, Avishek Banerjea, Radha Raman De, Avijit Hazra, Swapan Kumar Mandal
OBJECTIVES: To study medicine prescribing pattern for chronic kidney disease (CKD) patients on maintenance hemodialysis. MATERIALS AND METHODS: This prospective observational study was conducted in hemodialysis unit of a teaching hospital with adult CKD patients on maintenance hemodialysis. Patients' clinical profile, drug-use pattern, and medication-related problem data were captured in a structured case report form and the data were analyzed descriptively. Adherence level was assessed by Morisky Medication-Taking Adherence Scale 4-item...
September 2016: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/27701696/-severe-hypoglycemia-following-tramadol-intake-in-a-79-year-old-non-diabetic-patient
#18
Cornelius Kürten, Mladen Tzvetkov, Volker Ellenrieder, Harald Schwörer
History and clinical findings | We report about a 79 year old non-diabetic patient who was admitted to the emergency room with severe hypoglycemia (blood glucose level: 36 mg / dl and Glasgow Coma Scale Score: 3). After the infusion of G40 % her blood glucose level stabilised. The patient reported to have taken 50 mg of Tramadol during the night to treat her headache. Investigations and diagnosis | No other differential diagnosis for hypoglycemia (i.e. diabetes, insulinoma, severe liver or kidney disease) could be established...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27528374/safety-and-efficacy-of-incretin-based-therapies-in-patients-with%C3%A2-type-2-diabetes-mellitus-and-ckd-a-systematic-review%C3%A2-and-meta-analysis
#19
REVIEW
Patricia M Howse, Lyudmila N Chibrikova, Laurie K Twells, Brendan J Barrett, John-Michael Gamble
BACKGROUND: The pharmacokinetics and pharmacodynamics of antidiabetic therapies for patients with type 2 diabetes are often altered in the context of chronic kidney disease (CKD). STUDY DESIGN: Systematic review and meta-analysis. SETTING & POPULATION: Patients with type 2 diabetes and CKD. SELECTION CRITERIA FOR STUDIES: 2 reviewers independently screened studies identified through bibliographic databases (Cochrane Library, PubMed, Embase, International Pharmaceutical Abstracts), clinical trial registries, and references from pertinent articles and clinical practice guidelines...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27516879/an-updated-systematic-review-and-meta-analysis-on-the-efficacy-and-tolerability-of-dipeptidyl-peptidase-4-inhibitors-in-patients-with-type-2-diabetes-with-moderate-to-severe-chronic-kidney-disease
#20
Devada Singh-Franco, Catherine Harrington, Eglis Tellez-Corrales
OBJECTIVE: This updated meta-analysis determines the effect of dipeptidyl peptidase-4 inhibitors on glycemic and tolerability outcomes in patients with type 2 diabetes mellitus and chronic kidney disease with glomerular filtration rate of ⩽60 mL/min or on dialysis. METHODS: In all, 14 citations were identified from multiple databases. Qualitative assessments and quantitative analyses were performed. RESULTS: There were 2261 participants, 49-79 years of age, 49% men and 44% Caucasians...
2016: SAGE Open Medicine
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