Is the management of diabetes different in dialysis patients?

Coelho, Sílvia

doi:10.1111/sdi.12698

Cited by 6 publications

(3 citation statements)

References 103 publications

(161 reference statements)

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“…A study has shown that DPP-4 inhibitors combined with insulin can better reduce glycated hemoglobin (HbA1C) and insulin doses without increasing hypoglycemic events 17 . Some studies suggest that single or combined usage of DPP-4 inhibitors in patients with type 2 diabetes and CKD can ameliorate glycemic control without increasing AEs [18][19][20][21] . DPP-4 inhibitors also have renal protective effects and do not affect weight [22][23][24] .…”

Section: Introductionmentioning

confidence: 99%

Dipeptidyl peptidase‐4 inhibitor and insulin combination treatment in type 2 diabetes and chronic kidney disease: A meta‐analysis

Zhou

Zhu

et al. 2021

J of Diabetes Invest

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Aims/Introduction: The union of dipeptidyl peptidase-4 inhibitors and insulin in patients with type 2 diabetes and chronic kidney disease provides satisfactory glucose management without increasing adverse events (AEs). This research appraised the therapeutic effect and safety of combination therapy in patients with type 2 diabetes and chronic kidney disease. Materials and Methods: We carried out a meta-analysis of randomized controlled trials to analyze AEs, hypoglycemia, serious AEs, severe hypoglycemia, estimated glomerular filtration rate, fasting plasma glucose, glycated hemoglobin, insulin dose, low-density lipoprotein cholesterol, uric acid and weight between combination treatment groups and control groups by searching the Cochrane Library, Excerpta Medica Database (Embase), PubMed and Web of Science databanks until October 2020. Results: Five studies (6 trials, 1,278 participants) met the inclusion criteria. The evidence quality ranged from moderate to high. Glycated hemoglobin (standardized mean difference -0.29, 95% confidence interval -0.44 to -0.14) and insulin dose (standardized mean difference -0.16, 95% confidence interval -0.29 to -0.02) were obviously smaller in the combination cure patients than in the control patients. Compared with the control groups, combination treatment did not increase AEs, hypoglycemia, serious AEs or severe hypoglycemia.Conclusions: This study showed the effectiveness and safety of dipeptidyl peptidase-4 inhibitors bonded with insulin in patients with type 2 diabetes and chronic kidney disease, but the protective actions of this cure on kidney and cardiovascular outcomes, as well as the functions of other dipeptidyl peptidase-4 inhibitors, need to be affirmed by more good-quality randomized controlled trials.

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Section: Introductionmentioning

confidence: 99%

Dipeptidyl peptidase‐4 inhibitor and insulin combination treatment in type 2 diabetes and chronic kidney disease: A meta‐analysis

Zhou

Zhu

et al. 2021

J of Diabetes Invest

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“…Based on a similar population, a pilot study suggested that adding teneligliptin—another DPP‐4 inhibitor—to insulin decreased the incidence of hypoglycaemic episodes assessed by CGM, although insulin doses were voluntarily reduced by about a third from the first day of teneligliptin administration. A variable proportion of patients with diabetes undergoing haemodialysis may require insulin treatment, depending on the country and hospital, as well as on the practices that are specific to each diabetologist or nephrologist . Therefore, this study involving haemodialysed patients with type 2 diabetes sought to evaluate the effects of adding vildagliptin to insulin therapy on (i) glucose profiles using CGM and (ii) global metabolic control.…”

Section: Introductionmentioning

confidence: 99%

Effect of adding vildagliptin to insulin in haemodialysed patients with type 2 diabetes: The VILDDIAL study, a randomized, multicentre, prospective study

Munch¹,

Meyer²,

Hannedouche³

et al. 2020

Diabetes Obesity Metabolism

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Aim: To evaluate the effect of adding the dipeptidyl-peptidase-4 inhibitor vildagliptin to insulin on the glycaemic control of patients with type 2 diabetes undergoing haemodialysis.Methods: Overall, 65 insulin-treated patients with type 2 diabetes undergoing haemodialysis (HbA1c: 7.3% ± 1.1%; age: 70.5 ± 8.5 years) were randomized (1:1) either to receive vildagliptin 50 mg/day in addition to insulin (vildagliptin-insulin group) or to pursue their usual insulin regimen (insulin-only group). Continuous glucose monitoring (CGM) was performed for 48 ± 6 hours at baseline and at week 12. The primary This study was supported by Novartis Inc., France.

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“…While numerous research studies have been conducted in these areas, the use of surrogate outcomes and conflicting research results have left clinicians with little in the way of a unified or evidence‐based approach. To open this topic, the lifestyle, cardiovascular risk, and hyperglycemia management of diabetes in dialysis patients vs the general population is explored by Coelho . Dhillon‐Jhattu and Sprague then tackle the dilemma of hyperphosphatemia in the patient on dialysis, discussing pitfalls of the current guidelines and when and how to provide management .…”

mentioning

confidence: 99%