Challenges in achieving optimal glycemic control in type 2 diabetes patients with declining renal function: The Southeast Asia perspective

Journal of Diabetes Investigation

Francis CC Chow⁴  Siew-Pheng Chan³  Chii-Min Hwu²  Sompongse Suwanwalaikorn⁵  Akira YT Wu¹  Susan Yu Gan⁶ 

[1] Mount Elizabeth Medical Centre, Singapore;Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, PRC;Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia;Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR;Division of Endocrinology and Metabolism, Department of Medicine, Chulalongkorn University, Bangkok, Thailand;Department of Medicine, Metropolitan Medical Center, Quezon City

关键词: Chronic kidney disease;    Dipeptidyl‐peptidase IV inhibitors;    Type 2 diabetes;   

DOI  :  10.1111/jdi.12006

来源: Wiley

【 摘 要 】

Abstract

It is well recognised that Asia is at the epicenter of the global type 2 diabetes epidemic. Driven by socioeconomic changes involving industrialization, urbanization and adoption of Western lifestyles, the unprecedented increases in the prevalence of diabetes are particularly evident in Southeast Asia. The impact of diabetes is immense, and despite evidence of the benefit of optimal glucose control in reducing the risk of disease progression and development of macrovascular and microvascular complications, many individuals in this region remain poorly controlled. Chronic kidney disease (CKD) is an increasingly common diabetes-associated complication in Asian patients. Furthermore, Southeast Asia has one of the highest rates of end-stage renal disease (ESRD) in the world. Consequently, CKD in diabetes is associated with considerable morbidity and cardiovascular-related mortality, highlighting the need to screen and assess patients early in the course of the disease. The management of type 2 diabetes patients with declining renal function represents a significant challenge. Many of the older antidiabetic agents, such as metformin and sulfonylureas, are limited in their utility in CKD as a result of contraindications or hypoglycemic episodes. In contrast, dipeptidyl-peptidase IV inhibitors have provided a welcome addition to the therapeutic armamentarium for achieving glycemic control in these special populations. With comparable efficacy to and more favorable pharmacokinetic and side-effect profiles than traditional therapies, agents in this drug class, such as linagliptin, offer a more tailored approach to disease control in type 2 diabetes patients with declining renal function.

【 授权许可】

Unknown   
© 2012 Asian Association for the Study of Diabetes and Wiley Publishing Asia Pty Ltd