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hypoglycemia in chronic kidney disease

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https://www.readbyqxmd.com/read/29326106/risk-of-hypoglycemia-after-hospital-discharge-after-acute-kidney-injury-in-patients-with-diabetes
#1
Adriana M Hung, Edward D Siew, Otis D Wilson, Amy M Perkins, Robert A Greevy, Jeffrey Horner, Khaled Abdel-Kader, Sharidan K Parr, Christianne L Roumie, Marie R Griffin, T Alp Ikizler, Theodore Speroff, Michael E Matheny
OBJECTIVE: Hypoglycemia is common in patients with diabetes. The risk of hypoglycemia after acute kidney injury (AKI) is not well-defined. The purpose of this study was to compare the risk for postdischarge hypoglycemia among hospitalized patients with diabetes who do and do not experience AKI. RESEARCH DESIGN AND METHODS: We performed a propensity-matched analysis of patients with diabetes, with and without AKI, using a retrospective national cohort of veterans hospitalized between 2004 and 2012...
January 11, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29223646/exploring-the-effects-of-dpp-4-inhibitors-on-the-kidney-from-the-bench-to-clinical-trials
#2
REVIEW
Giuseppe Coppolino, Christian Leporini, Laura Rivoli, Francesco Ursini, Eugenio Donato di Paola, Valeria Cernaro, Franco Arturi, Davide Bolignano, Emilio Russo, Giovambattista De Sarro, Michele Andreucci
Dipeptidyl-peptidase-4 (DPP-4) inhibitors are a relatively new class of non-insulin glucose-lowering agents, belonging to the incretin family, which are able to improve glycemic control with a favorable safety profile, since they are associated with a low risk of hypoglycemia, no weight gain, and good tolerability in patients with chronic renal failure. Some experimental and clinical studies suggest that these drugs may exert significant pleiotropic effects, in particular on chronic kidney disease (CKD) progression, but data from clinical trials are still controversial...
December 6, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29200897/insulinoma-and-chronic-kidney-disease-an-uncommon-conundrum-not-to-be-overlooked
#3
Luca Foppiani, Serena Panarello, Marco Filauro, Maria Concetta Scirocco, Stefano Cappato, Andrea Parodi, Simona Sola, Giancarlo Antonucci
A hypertensive man with chronic kidney disease (CKD) secondary to polycystic disease was hospitalized for symptoms related to hypoglycemia. Fasting test elicited symptomatic hypoglycemia after 12 hours, which was associated with inappropriately unsuppressed normal insulin and C-peptide levels. Neither ultrasonography (US) nor magnetic resonance imaging detected any pancreatic tumor. Endoscopic ultrasonography (EUS) showed a small isoechogenic nodule suspect for neuroendocrine tumor in the pancreatic head...
2017: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/29159457/ertugliflozin-in-patients-with-stage-3-chronic-kidney-disease-and-type-2-diabetes-mellitus-the-vertis-renal-randomized-study
#4
George Grunberger, Sarah Camp, Jeremy Johnson, Susan Huyck, Steven G Terra, James P Mancuso, Zhi Wei Jiang, Gregory Golm, Samuel S Engel, Brett Lauring
INTRODUCTION: Ertugliflozin is a sodium-glucose cotransporter 2 inhibitor in development for type 2 diabetes mellitus (T2DM). The safety and efficacy of ertugliflozin were evaluated over 52 weeks in patients with chronic kidney disease (CKD). METHODS: In this double-blind randomized study (NCT01986855), patients with glycated hemoglobin (A1C) 7.0-10.5% and stage 3 CKD [estimated glomerular filtration rate (eGFR) ≥ 30 to < 60 mL/min/1.73 m(2)] who were undergoing treatment with standard diabetes therapy (or therapies) including insulin and/or sulfonylureas were randomized to once-daily ertugliflozin 5 mg, 15 mg, or placebo...
November 20, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29100450/meglitinides-increase-the-risk-of-hypoglycemia-in-diabetic-patients-with-advanced-chronic-kidney-disease-a-nationwide-population-based-study
#5
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...
September 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/29098423/hypoglycemia-reduction-strategies-in-the-icu
#6
REVIEW
Susan Shapiro Braithwaite, Dharmesh B Bavda, Thaer Idrees, Faisal Qureshi, Oluwakemi T Soetan
PURPOSE OF REVIEW: We reviewed the strategies associated with hypoglycemia risk reduction among critically ill non-pregnant adult patients. RECENT FINDINGS: Hypoglycemia in the ICU has been associated with increased mortality in a number of studies. Insulin dosing and glucose monitoring rules, response to impending hypoglycemia, use of computerization, and attention to modifiable factors extrinsic to insulin algorithms may affect the risk for hypoglycemia. Recurring use of intravenous (IV) bolus doses of insulin in insulin-resistant cases may reduce reliance upon higher IV infusion rates...
November 2, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28983844/the-role-of-vildagliptin-in-the-therapy-of-type-2-diabetic-patients-with-renal-dysfunction
#7
REVIEW
Roberto Trevisan
Diabetes is the leading cause of chronic kidney disease, and even in the absence of albuminuria, decreased renal function in type 2 diabetes mellitus (T2DM) patients increases the risk for major adverse cardiovascular events and death. The evidence derived from recent studies suggests that intensive glucose control not only reduces the risk for microalbuminuria and macroalbuminuria but may also decrease the rate of decline of glomerular filtration rate (GFR). Although insulin therapy is widely used in patients with T2DM and renal disease, metabolic control is particularly difficult to achieve and manage because of the limited therapeutic options and the frequent comorbidities seen in this population...
December 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28977090/use-of-sglt-2-inhibitors-in-the-treatment-of-type-2-diabetes-mellitus
#8
REVIEW
Leyna Leite Santos, Fernando José Camello de Lima, Célio Fernando de Sousa-Rodrigues, Fabiano Timbó Barbosa
INTRODUCTION: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. OBJECTIVE: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile...
July 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28842165/chronic-kidney-disease-basal-insulin-glargine-and-health-outcomes-in-people-with-dysglycemia-the-origin-study
#9
Vasilios Papademetriou, Eric S Nylen, Michael Doumas, Jeff Probstfield, Johannes F E Mann, Richard E Gilbert, Hertzel C Gerstein
BACKGROUND: Early stages of chronic kidney disease are associated with an increased cardiovascular risk in patients with established type 2 diabetes and macrovascular disease. The role of early stages of chronic kidney disease on macrovascular outcomes in prediabetes and early type 2 diabetes mellitus is not known. In the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial, the introduction of insulin had no effect on cardiovascular outcomes compared with standard therapy...
August 31, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28828479/development-and-validation-of-a-tool-to-identify-patients-with-type-2-diabetes-at-high-risk-of-hypoglycemia-related-emergency-department-or-hospital-use
#10
MULTICENTER STUDY
Andrew J Karter, E Margaret Warton, Kasia J Lipska, James D Ralston, Howard H Moffet, Geoffrey G Jackson, Elbert S Huang, Donald R Miller
Importance: Hypoglycemia-related emergency department (ED) or hospital use among patients with type 2 diabetes (T2D) is clinically significant and possibly preventable. Objective: To develop and validate a tool to categorize risk of hypoglycemic-related utilization in patients with T2D. Design, Setting, and Participants: Using recursive partitioning with a split-sample design, we created a classification tree based on potential predictors of hypoglycemia-related ED or hospital use...
October 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28758978/dietary-approaches-in-the-management-of-diabetic-patients-with-kidney-disease
#11
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
#12
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
#13
Morena Ustulin, Junghoon Woo, Jeong-Taek Woo, Sang Youl Rhee
AIMS/INTRODUCTION: Frequent emergency department (ED) visitors are medically vulnerable individuals. We identified the characteristics of "frequent ED users" among Korean patients with type 2 diabetes mellitus. MATERIALS AND METHODS: We used the Health Insurance Review and Assessment Service National Patient Sample, which is a nationally representative sample. Patients (n = 109,412) with type 2 diabetes mellitus 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
#14
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
#15
RANDOMIZED CONTROLLED TRIAL
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...
August 24, 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
#16
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
#17
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) ) vs those without CKD...
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
#18
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
#19
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
#20
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
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