Hypoglycemia in patient with chronic kidney disease
DOI:
https://doi.org/10.47196/diab.v51i3.108Keywords:
hypoglycemia, chronic kidney disease, morbidity, mortalityAbstract
The strict blood glucose monitoring has proved to reduce the in- cidence and progression of chronic complications, with the resul- ting increase of hypoglycemia risk. At present, the American Association of Diabetes classifies: Level 1: warning of hypoglycemia <70 mg/dl; Level 2: clinically significant hypoglycemia <54 mg/ dl; Level 3: severe hypoglycemia, in which without specifying the value of glycemia, it is necessary the help of third parties or cognitive alterations appear. Hypoglycemia is usually less frequent in patients with type 2 diabetes rather than type 1 diabetes; it is associated with the high morbidity and mortality, representing frequently one of the principal barriers to attain an optimal glycemia control. Patients with reduced glomerular filtration (GF) (<60 ml/min/1.73 m2) frequently present less insulin requirements and decrease of insulin degradation in peripheral tissue, which are risk factors for the development of severe hypoglycemia.
References
Luboswsky ND, Siegel R, Pittas AG, et al. Manegment of glycemia in patients with diabetes mellitus and CDK. Am J Kidney Dis 2007; 50(5):865-879.
UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352(9131): 837-53.
Khaw KT, Wareham N, Luben R, et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of european prospective investigation of cancer and nutrition (EPIC-Norfolk). BMJ 2001; 322(7277):15-18.
Standars of Medical Care. American Diabetes Association. Glycemic targets. Diabetes Care 2017; 40(Suppl. 1): S48-S56.
Akram K, Pedersen-Bjergaard U, Borch-Johnsen K. Frecuency and risk factors of severe hypoglycemia in insulin treated type 2 diabetes: a literatura survey. J Diabetes Complications 2006; 20(6): 402-408.
The ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008; 358(24): 2560-72.
Robinson RT, Harris ND, Ireland RH, et al. Mechanisms of abnormal cardiac repolarization during insulin-induced hypoglycemia. Diabetes 2003; 52(6): 1469-74.
Biesenbach G, Raml A, Schemeckal B, et al. Decreased insulin requirement in relation to GRF in nephopatic type 1 and insulin-treated type 2 diabetic patients. Diabet Med 2003; 20(8): 642-5.
Snyder RW, Bernds JS. Use of insulin and oral hypo- glycemic medications in patients with diabetes mellitus and advanced kidney desease. Semin Dial 2004; 17(5): 665-70.
Moen MF, Zhan M, Hsu VD, et al. Frequency of hypo- glycemia and its significance in chronic kidney disease. Clin J Am Soc Nephrol 2009; 4(6):1121-7.
Jae-Seung Y, Sun-Hye K, Sun-Hee K, et al. Presence of macroalbuminuria predicts severe hypoglycemia in patients with type 2 diabetes. Diabetes Care 2013; 36(5): 1283-89.
Collins AJ, Foley RN, Herzog C, et al. US Renal Data System 2012 Annual Data Report. Am J Kidney Dis 2013; 61 (1 Suppl 1): e1-e476.
New JP, Middleton RJ, Klebe B, et al. Assessing the prevalence, monitoring and management of chronic kidney disease in patients with diabetes compared with those without diabetes in general practice. Diabet Med 2007; 24(4): 364-9.
Gerich JE, Mokan M, Veneman T, et al. Hypoglycemia unawareness. Endocr Rev 1991; 12(4):356-71.
Mühlhauser I, Toth G, Sawicki PT, et al. Severe hypo- glycemia in type I diabetic patients with impaired kidney function. Diabetes Care 1991; 14(4): 344-346.
Zammitt NN, Frier BM. Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities. Diabetes Care 2005; 28(5): 2948-61.
Amiel SA, DixonT, Mann R. Hypoglucemia in type 2 diabetes. Diabet Med 2008; 25(3):245-54.
Taylor JR, Dietrich E, Powell JG. New and emerging pharmacologic therapies for type 2 diabetes, dyslipidemia, and obesity. ClinTher 2013; 35: A3-A17.
Holman RR, Farmer AJ, Davies MJ, et al. Three-year efficacy of complex insulin regimens in type 2 diabetes. N Engl J Med 2009; 361(18):1736-47.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.
La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.
Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.
