ISN-ISE Webinar: practical aspects of the treatment of diabetic kidney disease
In patients with CKD the decline in GFR reduces the clearance of insulin and many diabetes medications and raises the risk of hypoglycemia with insulin, sulfonylureas and glinides.GLP1agonists have cardiovascular benefits, andSGLT2 inhibitors significantly decrease kidney and cardiovascular outcomes making them the class of choice for those with CKD. Targets for glycemic control should be individualized taking CKD into consideration, and glycemic control should be monitored with HbA1c, supplemented with SMBG or CGM when hypoglycemia is of concern. Multidisciplinary teamwork with collaboration between GP, endocrinologist and nephrologist is important for success.
- Understand which medications are most useful in preventing CKD progression
- List at least 3 medications whose doses need to be reduced with advancing CKD to avoid hypoglycemia
- List at least 2 classes of medications known to reduce cardiovascular outcomes in patients with diabetes.
- Know how to monitor glycemic control in CKD
- Understand the need for collaboration between specialists Diabetes mellitus, chronic kidney disease, CKD, GFR, SGLT-2, GLP-1, insulin, sulfonylurea, DPP-4, cardiovascular, heart, hemoglobinA1c