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Quality of diabetes mellitus therapy in patients with chronic kidney disease in the real world

机译：现实世界中慢性肾脏病患者糖尿病治疗的质量

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Chronic kidney disease (CKD) is very often among diabetic patients. Some oral antidiabetic agents are not recommended in the presence of CKD. Aim of the study was to evaluate the quality of diabetes mellitus (DM) treatment in nephrophatic patients in the real world. A total of 265 subjects with type 2 DM, consecutively admitted to the internal medicine departments of two hospitals in Rome, were recruited. Patients hospitalized for hypoglycemia, decompensated DM, acute kidney failure or worsening nephropathy were excluded. For each patient, the following data were collected: age, gender, estimated glomerular filtration rate (eGFR) using the MDRD ( modification of diet in renal disease ) study equation, type of antidiabetic drug treatment. A total of 265 subjects were studied, 127 male (47.9%) and 138 female (52.1%). The mean age was 77.5 years. The mean of glycemia glycated hemoglobin (HbA1c) value was 57.5 mmol/mol (7.4%). 137 patients (51.7%) were treated with oral antidiabetic agents, 29 (10%) with both oral antidiabetic agents and insulin, 90 (34%) with insulin alone, 8 (3%) with dipeptidyl peptidase-4 inhibitors, 1 (0.4%) with incretin agents plus oral antidiabetic drugs. According to the Kidney Disease Outcomes Quality Initiative (KDOQI) classification of CKD, the sample was divided into 5 groups using eGFR criteria. For each group, mean HbA1c values, type of antidiabetic treatment, appropriateness of therapy according to guidelines and how it may affect the HbA1c levels were considered. Our data show that 30.5% of patients with CKD stage 3-5 is treated with drugs not recommended by current guidelines.
机译：慢性肾脏病（CKD）在糖尿病患者中非常常见。不建议在CKD存在下使用某些口服降糖药。该研究的目的是评估现实世界中肾病患者的糖尿病（DM）治疗质量。总共招募了265名2型DM受试者，这些受试者连续被罗马的两家医院的内科接受治疗。排除因低血糖，DM代偿失调，急性肾衰竭或肾病恶化而住院的患者。对于每位患者，收集以下数据：年龄，性别，使用MDRD（肾脏疾病饮食的调整）研究方程式估计的肾小球滤过率（eGFR），抗糖尿病药物治疗的类型。共研究了265位受试者，其中男性127位（47.9％），女性138位（52.1％）。平均年龄为77.5岁。血糖平均糖化血红蛋白（HbA1c）值为57.5 mmol / mol（7.4％）。口服抗糖尿病药治疗137例患者（51.7％），口服抗糖尿病药和胰岛素治疗29例（10％），单独使用胰岛素治疗90例（34％），使用二肽基肽酶4抑制剂治疗8例（3％），1（0.4 ％）与肠降血糖素药物加口服降糖药。根据肾脏疾病结局质量倡议（KDOQI）对CKD的分类，使用eGFR标准将样品分为5组。对于每组，均应考虑平均HbA1c值，抗糖尿病治疗的类型，根据指导原则的治疗适当性及其对HbA1c水平的影响。我们的数据显示，有3-5％CKD 3-5期患者接受了当前指南未推荐的药物治疗。

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