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Hypoglycemia in ckd

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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
#1
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 Nrpb Kidney Consortium
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
#2
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/28245289/hypoglycemia-following-intravenous-insulin-plus-glucose-for-hyperkalemia-in-patients-with-impaired-renal-function
#3
Armando Coca, Ana Lucia Valencia, Jesus Bustamante, Alicia Mendiluce, Jürgen Floege
BACKGROUND: Hypoglycemia is a serious complication following the administration of insulin for hyperkalemia. We determined the incidence of hypoglycemia and severe hypoglycemia (blood glucose <70 or ≤40 mg/dl, respectively) in a cohort of AKI and non-dialysis dependent CKD patients who received an intravenous infusion of insulin plus glucose to treat hyperkalemia. METHODS: We retrospectively reviewed charts of all AKI and non-dialysis dependent CKD patients who received 10 U of insulin plus 50 g glucose to treat hyperkalemia from December 1, 2013 to May 31, 2015 at our Department...
2017: PloS One
https://www.readbyqxmd.com/read/28225432/the-use-of-dipeptidyl-peptidase-4-inhibitors-in-patients-with-type-2-diabetes-chronic-kidney-disease
#4
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
#5
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
#6
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...
February 9, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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/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
#13
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
#14
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
https://www.readbyqxmd.com/read/27513562/anti-hyperglycemic-agents-and-new-onset-acute-myocardial-infarction-in-diabetic-patients-with-end-stage-renal-disease-undergoing-dialysis
#15
Ting-Tse Lin, Chih-Chen Wu, Yao-Hsu Yang, Lian-Yu Lin, Jiunn-Lee Lin, Pau-Chung Chen, Juey-Jen Hwang
BACKGROUND: Diabetes and chronic kidney disease (CKD) are a high-stakes combination for cardiovascular disease. Patients with decreased kidney function and end-stage renal disease (ESRD) have increased risk of hypoglycemia when attaining better glycemic control, leading to higher risk of myocardial infarction (MI). For these patients, which kinds of anti-hyperglycemic agents would be associated with higher risk of MI is not clear. METHODS: We identified patients from a nation-wide database called Registry for Catastrophic Illness, which encompassed almost 100% of the patients receiving dialysis therapy in Taiwan from 1995 to 2008...
2016: PloS One
https://www.readbyqxmd.com/read/27436577/progressive-development-of-renal-cysts-in-glycogen-storage-disease-type-i
#16
Monika Gjorgjieva, Margaux Raffin, Adeline Duchampt, Ariane Perry, Anne Stefanutti, Marie Brevet, Antonin Tortereau, Laurence Dubourg, Aurélie Hubert-Buron, Mylène Mabille, Coralie Pelissou, Louis Lassalle, Philippe Labrune, Gilles Mithieux, Fabienne Rajas
Glycogen storage disease type I (GSDI) is a rare metabolic disease due to glucose-6 phosphatase deficiency, characterized by fasting hypoglycemia. Patients also develop chronic kidney disease whose mechanisms are poorly understood. To decipher the process, we generated mice with a kidney-specific knockout of glucose-6 phosphatase (K.G6pc(-/-) mice) that exhibited the first signs of GSDI nephropathy after 6 months of G6pc deletion. We studied the natural course of renal deterioration in K.G6pc(-/-) mice for 18 months and observed the progressive deterioration of renal functions characterized by early tubular dysfunction and a later destruction of the glomerular filtration barrier...
July 19, 2016: Human Molecular Genetics
https://www.readbyqxmd.com/read/27402391/saxagliptin-efficacy-and-safety-in-patients-with-type-2-diabetes-and-moderate-renal-impairment
#17
Shira Perl, William Cook, Cheryl Wei, Nayyar Iqbal, Boaz Hirshberg
INTRODUCTION: Type 2 diabetes (T2D) is the leading cause of chronic kidney disease (CKD). The recommended dose of the dipeptidyl peptidase-4 inhibitor saxagliptin is 2.5 mg in patients with moderate or severe renal impairment (creatinine clearance ≤50 mL/min). In this post hoc analysis, we assessed the effect of saxagliptin 2.5 and 5 mg/day versus placebo on glycemic measures in patients with T2D and estimated glomerular filtration rate 45-60 mL/min/1.73 m(2). METHODS: Efficacy and safety data were pooled from nine 24-week, randomized, placebo-controlled clinical trials...
September 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27246619/clinical-characteristics-and-outcomes-of-the-oldest-old-people-with-type-2-diabetes-perspective-from-a-tertiary-diabetes-center-in-thailand
#18
Thewjitcharoen Yotsapon, Krittiyawong Sirinate, Wanothayaroj Ekgaluck, Vongterapak Somboon, Anuntakulnatee Tawee, Kittipoom Worawit, Nakasatien Soontaree, Himathongkam Thep
BACKGROUND: Advance in medicine has led to an increase in life expectancy of elderly diabetic patients especially on the growing population called the "oldest old", those in their mid-80s upwards. The aim of this study is to describe clinical characteristics and outcomes of "oldest old" patients in a specialized diabetes center. METHODS: A retrospective review was conducted on medical records of type 2 diabetes who were older than 85 years at Theptarin hospital from September 2014 to August 2015...
June 1, 2016: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/27230267/patient-reported-safety-events-in-chronic-kidney-disease-recorded-with-an-interactive-voice-inquiry-dial-response-system-monthly-report-analysis
#19
Jeffrey C Fink, Rebecca M Doerfler, Marni R Yoffe, Clarissa J Diamantidis, Jacob B Blumenthal, Tariq Siddiqui, James F Gardner, Soren Snitker, Min Zhan
BACKGROUND: Monitoring patient-reported outcomes (PROs) may improve safety of chronic kidney disease (CKD) patients. OBJECTIVE: Evaluate the performance of an interactive voice-inquiry dial-response system (IVRDS) in detecting CKD-pertinent adverse safety events outside of the clinical environment and compare the incidence of events using the IVDRS to that detected by paper diary. METHODS: This was a 6-month study of Stage III-V CKD patients in the Safe Kidney Care (SKC) study...
May 26, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27055204/managing-diabetes-in-hospitalized-patients-with-chronic-kidney-disease
#20
REVIEW
Shridhar N Iyer, Robert J Tanenberg
Because few randomized trials have been done, little is known about appropriate glycemic control in hospitalized patients with chronic kidney disease (CKD) and diabetes mellitus. These patients are at high risk of hypoglycemia. It is prudent to monitor glucose closely, set less-stringent blood sugar goals, avoid oral antidiabetic agents, and possibly reduce insulin dosage.
April 2016: Cleveland Clinic Journal of Medicine
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