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

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          Abstract

          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.

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          Most cited references 51

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          KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease.

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            Diabetic neuropathies: a statement by the American Diabetes Association.

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              KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease

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                Author and article information

                Journal
                Drug Des Devel Ther
                Drug Des Devel Ther
                Drug Design, Development and Therapy
                Drug Design, Development and Therapy
                Dove Medical Press
                1177-8881
                2015
                07 August 2015
                : 9
                : 4355-4371
                Affiliations
                [1 ]Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
                [2 ]Clinical Investigation Centre, University Malaya Medical Centre, Kuala Lumpur, Malaysia
                [3 ]Renal Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
                Author notes
                Correspondence: Hasniza Zaman Huri, Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603, Malaysia, Tel +60 3 7967 6659, Fax +60 3 7967 4964, Email hasnizazh@ 123456um.edu.my
                Article
                dddt-9-4355
                10.2147/DDDT.S85676
                4535549
                © 2015 Huri et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Original Research

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