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Julie Maria Bøggild Brøsen1, Tobias Bomholt2, Rikke Borg3,4

  • 1Endokrinologisk og Nefrologisk Afdeling, Københavns Universitetshospital - Nordsjællands Hospital - Hillerød.

Ugeskrift for Laeger
|May 29, 2024
PubMed
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Managing high blood sugar in diabetes and chronic kidney disease (CKD) is complex. This review covers reliable glucose monitoring and safe treatment options for patients with diabetes and CKD.

Area of Science:

  • Nephrology
  • Endocrinology
  • Metabolic Diseases

Background:

  • Hyperglycaemia management in diabetes and chronic kidney disease (CKD) presents unique challenges.
  • Glycated hemoglobin (HbA1c) may be unreliable in advanced CKD, necessitating alternative glucose monitoring methods.
  • Individualized risk assessment, particularly for hypoglycaemia, is crucial for treatment selection.

Purpose of the Study:

  • To provide a comprehensive overview of glycaemic monitoring techniques for individuals with diabetes and CKD.
  • To review available glucose-lowering treatment options suitable for patients with varying stages of CKD.
  • To emphasize the importance of personalized treatment strategies considering CKD severity and hypoglycaemia risk.

Main Methods:

  • Literature review of current guidelines and research on diabetes management in CKD.

Related Experiment Videos

  • Analysis of glucose-lowering medications and their efficacy and safety profiles in CKD populations.
  • Evaluation of different continuous glucose monitoring (CGM) and blood glucose monitoring (BGM) strategies.

    • Main Results:

    • HbA1c limitations in advanced CKD highlight the need for supplementary glucose measurements like CGM or BGM.
    • Glucose-lowering treatments require careful selection based on CKD stage and individual hypoglycaemia risk.
    • A tailored approach to both monitoring and treatment is essential for optimal outcomes.

    Conclusions:

    • Effective management of hyperglycaemia in diabetes and CKD necessitates a shift from sole reliance on HbA1c to utilizing advanced monitoring tools.
    • Treatment decisions for glucose lowering must prioritize patient safety, with a strong focus on minimizing hypoglycaemia risk in the context of CKD.
    • Personalized glycaemic control strategies are paramount for improving the health and well-being of individuals with comorbid diabetes and CKD.