Glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with renal complications.

Drug Des Devel Ther 2015 7;9:4355-71. Epub 2015 Aug 7.

Renal Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Background: Good glycemic control can delay the progression of kidney diseases in type 2 diabetes mellitus (T2DM) patients with renal complications. To date, the association between antidiabetic agents and glycemic control in this specific patient population is not well established.

Purpose: This study aimed to identify antidiabetic regimens as well as other factors that associated with glycemic control in T2DM patients with different stages of chronic kidney disease (CKD).

Patients And Methods: This retrospective, cross-sectional study involved 242 T2DM inpatients and outpatients with renal complications from January 2009 to March 2014 and was conducted in a tertiary teaching hospital in Malaysia. Glycated hemoglobin (A1C) was used as main parameter to assess patients' glycemic status. Patients were classified to have good (A1C <7%) or poor glycemic control (A1C ≥7%) based on the recommendations of the American Diabetes Association.

Results: Majority of the patients presented with CKD stage 4 (43.4%). Approximately 55.4% of patients were categorized to have poor glycemic control. Insulin (57.9%) was the most commonly prescribed antidiabetic medication, followed by sulfonylureas (43%). Of all antidiabetic regimens, sulfonylureas monotherapy (P<0.001), insulin therapy (P=0.005), and combination of biguanides with insulin (P=0.038) were found to be significantly associated with glycemic control. Other factors including duration of T2DM (P=0.004), comorbidities such as anemia (P=0.024) and retinopathy (P=0.033), concurrent medications such as erythropoietin therapy (P=0.047), α-blockers (P=0.033), and antigouts (P=0.003) were also correlated with A1C.

Conclusion: Identification of factors that are associated with glycemic control is important to help in optimization of glucose control in T2DM patients with renal complication.

Download full-text PDF

Source
http://dx.doi.org/10.2147/DDDT.S85676DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535549PMC
April 2016
28 Reads

Publication Analysis

Top Keywords

glycemic control
16
renal complications
12
diabetes mellitus
8
type diabetes
8
patients renal
8
t2dm patients
8
glycemic
5
ckdpatients methods
4
kidney disease
4
disease ckdpatients
4
methods retrospective
4
retrospective cross-sectional
4
t2dm inpatients
4
242 t2dm
4
involved 242
4
study involved
4
cross-sectional study
4
stages chronic
4
antidiabetic regimens
4
identify antidiabetic
4

Similar Publications