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Consensus statement on insulin therapy in chronic kidney disease.
Rajesh Rajput1, Binayak Sinha2, Sujoy Majumdar3
1Dept of Endocrinology, PGIMS, Rohtak, India.
Diabetes Research and Clinical Practice
|March 19, 2017
Summary
Guidelines for insulin dosing in diabetic kidney disease (DKD) are now available. These recommendations help healthcare providers adjust insulin therapy for patients with DKD, improving glycemic control.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Diabetes mellitus (DM) is a primary cause of chronic kidney disease (CKD).
- Diabetic kidney disease (DKD) leads to insulin resistance and reduced insulin clearance.
- Insulin requirements decrease in DKD patients, necessitating dose adjustments.
Purpose of the Study:
- To offer primary care physicians simple guidelines for insulin dosing in DKD.
- To provide clear instructions on titrating various insulin regimens for DKD patients.
Main Methods:
- Evaluated basal, prandial, premix, and basal-bolus insulin regimens.
- Incorporated data from medical literature on CKD and insulin therapy.
- Considered Indian clinical practices and expert opinions.
Main Results:
- Developed recommendations for insulin dosing and titration in DKD.
- Established strategies for insulin dose estimation and optimal glycemic targets.
- Included recommendations for self-monitoring of blood glucose in DKD patients.
Conclusions:
- Consensus-based recommendations serve as a valuable reference for managing insulin therapy in DKD.
- These guidelines aid healthcare practitioners in initiating, optimizing, and intensifying insulin treatment.
- The recommendations support individualized insulin therapy for DKD patients.
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