Single- and multiple-dose pharmacokinetics of repaglinide in patients with type 2 diabetes and renal impairment

Schumacher, Svenja; Abbasi, I.; Weise, D W; Hatorp, Vibeke; Sattler, Katherine; Sieber, Jochen; Hasslacher, Christoph

doi:10.1007/s002280100280

Cited by 83 publications

(24 citation statements)

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“…Similarly, α-glucosidase inhibitors (acarbose and miglitol) are also contraindicated in patients with renal failure, whereas the non-sulfonylurea insulin secretagogues repaglinide and nateglinide can be used in patients with renal failure without dose adjustments [29]. In the absence of contraindications, metformin is preferred over other agents due to equal potency and a low risk of hypoglycemia, and also as it causes less weight gain compared with insulin secretagogues.…”

Section: Discussionmentioning

confidence: 99%

The Association of Pioglitazone and Urinary Tract Disease in Type 2 Diabetic Taiwanese: Bladder Cancer and Chronic Kidney Disease

Lee

Hsiao²,

Yang³

et al. 2014

PLoS ONE

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ObjectiveAlthough studies have shown an association between pioglitazone and bladder cancer, the associated factors have not been identified. The aim of this study was to investigate the factors that may link pioglitazone to bladder cancer.Materials and MethodsIn total, 34,970 study subjects were identified from the National Health Insurance Research Database in 2003 with follow-up from 2005 to 2009. The demographic characteristics of patients who had used and had never used pioglitazone, including age, sex, diabetes duration, urinary tract disease, nephropathy, bladder cancer, and cumulative dose and duration of pioglitazone therapy, were analyzed using the χ2 test. Cox proportional hazard regression models were used to determine the independent effects of pioglitazone on bladder cancer and newly developed chronic kidney disease.ResultsAmong 3,497 ever users and 31,473 never users of pioglitazone, the respective incident cases of bladder cancer were 12 (0.4%) and 72 (0.2%), and for newly developed chronic kidney disease 245 (8.1%) and 663 (2.3%), respectively. Ever use of pioglitazone [1.59(1.32–1.91)], cumulative dose of pioglitazone <10,500 mg [1.69 (1.37–2.01)] and >10,500 mg [1.34 (1.04–1.73)], and duration of therapy <12 months [1.68 (1.36–2.08)] and >12 months [1.39 (1.09–1.76)] were associated with the development of chronic kidney disease.ConclusionsThere was no association of pioglitazone use with bladder cancer development, however, there was an association with an increased risk of newly developed chronic kidney disease.

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Section: Discussionmentioning

confidence: 99%

The Association of Pioglitazone and Urinary Tract Disease in Type 2 Diabetic Taiwanese: Bladder Cancer and Chronic Kidney Disease

Lee

Hsiao²,

Yang³

et al. 2014

PLoS ONE

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“…This is not surprising since glinides have primarily a role in the treatment of T2DM when an oral agent is needed in case of RI 38. It is, however, unclear that glinides offer any advantages over SUs in terms of hypoglycemia, and several meta-analyses from the literature have concluded against any hypoglycemic benefit of this class compared with SUs 39,40.…”

Section: Discussionmentioning

confidence: 99%

How are patients with type 2 diabetes and renal disease monitored and managed? Insights from the observational OREDIA study

Penfornis¹,

Blicklé²,

Fiquet³

et al. 2014

VHRM

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Background and aimChronic kidney disease (CKD) is frequent in type 2 diabetes mellitus (T2DM), and therapeutic management of diabetes is more challenging in patients with renal impairment (RI). The place of metformin is of particular interest since most scientific societies now recommend using half the dosage in moderate RI and abstaining from use in severe RI, while the classic contraindication with RI has not been removed from the label. This study aimed to assess the therapeutic management, in particular the use of metformin, of T2DM patients with CKD in real life.MethodsThis was a French cross-sectional observational study: 3,704 patients with T2DM diagnosed for over 1 year and pharmacologically treated were recruited in two cohorts (two-thirds were considered to have renal disease [CKD patients] and one-third were not [non-CKD patients]) by 968 physicians (81% general practitioners) in 2012.ResultsCKD versus non-CKD patients were significantly older with longer diabetes history, more diabetic complications, and less strict glycemic control (mean glycated hemoglobin [HbA1c] 7.5% versus 7.1%; 25% of CKD patients had HbA1c ≥8% versus 15% of non-CKD patients). Fifteen percent of CKD patients had severe RI, and 66% moderate RI. Therapeutic management of T2DM was clearly distinct in CKD, with less use of metformin (62% versus 86%) but at similar mean daily doses (~2 g/d). Of patients with severe RI, 33% were still treated with metformin, at similar doses. For other oral anti-diabetics, a distinct pattern of use was seen across renal function (RF): use of sulfonylureas (32%, 31%, and 20% in normal RF, moderate RI, and severe RI, respectively) and DPP4-i (dipeptidyl peptidase-4 inhibitors) (41%, 36%, and 25%, respectively) decreased with RF, while that of glinides increased (8%, 14%, and 18%, respectively). CKD patients were more frequently treated with insulin (40% versus 16% of non-CKD patients), and use of insulin increased with deterioration of RF (19%, 39%, and 61% of patients with normal RF, moderate RI, and severe RI, respectively). Treatment was modified at the end of the study-visit in 34% of CKD patients, primarily to stop or reduce metformin. However, metformin was stopped in only 40% of the severe RI patients.ConclusionDespite a fairly good detection of CKD in patients with T2DM, RI was insufficiently taken into account for adjusting anti-diabetic treatment.

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“…Repaglinide can accumulate in patients with advanced renal dysfunction (eGFR <30 mL/min/1.73 m 2 ) without significant increase in hypoglycemia [75]. A metabolite of nateglinide, that has modest hypoglycemic effect, accumulates in patients with CKD [76].…”

Section: Therapeutic Considerationsmentioning

confidence: 99%

Hypoglycemia in Patients with Diabetes and Renal Disease

Alsahli

Gerich

2015

JCM

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Single- and multiple-dose pharmacokinetics of repaglinide in patients with type 2 diabetes and renal impairment

Cited by 83 publications

References 0 publications

The Association of Pioglitazone and Urinary Tract Disease in Type 2 Diabetic Taiwanese: Bladder Cancer and Chronic Kidney Disease

The Association of Pioglitazone and Urinary Tract Disease in Type 2 Diabetic Taiwanese: Bladder Cancer and Chronic Kidney Disease

How are patients with type 2 diabetes and renal disease monitored and managed? Insights from the observational OREDIA study

Hypoglycemia in Patients with Diabetes and Renal Disease

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